PREVALENCIJA SINDROMA NISKE PREDNJE RESEKCIJE KOD BOLESNIKA SA KARCINOMOM REKTUMA KOJI SU BILI PODVRGNUTI HIRURŠKOM LEČENJU U GRADSKOJ BOLNICI ISFAHAN TOKOM 2012-2018

  • Behnam Sanei Associate Professor of Kidney Transplantation, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences
  • Mohammad Ghasemi Fard Resident of General Surgery, Department of Surgery, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences
  • Mohsen Kolahduzan Associate Professor of Thoracic Surgery, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences

Sažetak


Objective. We aimed to determine the relative frequency of low anterior resection syndrome (LARS) in patients with rectal cancers who underwent surgical treatment in Isfahan.

Methods. We evaluated all patients who referred to the surgery clinic of Saint Al-Zahra hospital in Isfahan within six years. After identifications, if LARS, according to the LARS score tool, the frequency of resection complications, factors affecting the LARS, morbidity, and mortality, the frequency distribution of defecation, stool consistency, and rate of significant improvement was evaluated.

Results. Fifty-two patients were evaluated. The prevalence of LARS was 78.8%. Postoperative fecal and gas incontinence, clustering, fecal frequency, and fecal urgency in LARS patients were significantly higher than patients without LARS (P<0.05). There was no significant difference between the two groups in terms of factors affecting the LARS (p<0.05). In most of the patients with LARS, the defecation frequency was more than seven times a week (82.1%), and they mostly had liquid stool (61.5%). 95.5%. Of the patients with LARS showed significant improvement, which was mostly after 11-7 months (38.5). There was a significant difference between the frequency distribution of defecation, stool consistency, and significant improvement status in patients with and without LARS.

Conclusion. LARS occurs commonly among patients undergoing LAR with TME and is associated with more resection complications. Patients with LARS have a significantly higher frequency of defecation per week and liquid stools and mostly achieve significant improvements. Other factors might not be significantly different between patients with or without LARS.

Reference

Fazeli M S, Keramati M R. Rectal cancer: a review. Med J Islam Repub Iran. 2015; 29 (1) :83-104.

Marley AR, Nan H. Epidemiology of colorectal cancer. Int. J. Mol. Epidemiology Genet. 2016; 7: 105-14.

Yang J, Du XL, Li ST, et al. Characteristics of differently located colorectal cancers support proximal and distal classification: a population-based study of 57,847 patients. PLoS One 2016; 11: e0167540-e. (doi: 10.1371/journal.pone.0167540).

Keeler BD, Mishra A, Stavrou CL, Beeby S, Simpson JA, Acheson AG. A cohort investigation of anaemia, treatment and the use of allogeneic blood transfusion in colorectal cancer surgery. Ann Med Surg (Lond) 2015; 6: 6-11.

Plummer JM, Leake P-A, Ferron-Boothe D, Roberts PO, Mitchell DI, McFarlane ME. Colorectal cancer survival in Jamaica. Ann Med Surg (Lond) 2016; 6: 26-9.

Ansa BE, Coughlin SS, Alema-Mensah E, Smith SA. Evaluation of colorectal cancer incidence trends in the United States (2000-2014). J Clin Med 2018; 7: 22. (doi: 10.3390/jcm7020022).

Rafiemanesh H, Pakzad R, Abedi M, et al. Colorectal cancer in Iran: Epidemiology and morphology trends. EXCLI J 2016; 15: 738-44.

Wei EK, Giovannucci E, Wu K, Rosner B, Fuchs CS, Willett WC, et al. Comparison of risk factors for colon and rectal cancer. Int J Cancer 2004; 108: 433-42.

Johnson CM, Wei C, Ensor JE, et al. Meta-analyses of colorectal cancer risk factors. Cancer Causes Control 2013; 24: 1207-22.

Vega P, Valentín F, Cubiella J. Colorectal cancer diagnosis: pitfalls and opportunities. World J Gastrointest Oncol 2015; 7: 422-33.

Swiderska M, Choromańska B, Dąbrowska E, et al. The diagnostics of colorectal cancer. Contemp Oncol (Pozn) 2014; 18: 1-6.

Zhang Y, Chen Z, Li J. The current status of treatment for colorectal cancer in China: a systematic review. Medicine 2017; 96: e8242. (doi: 10.1097/MD.0000000000008242).

Keane C, Wells C, O'Grady G, Bissett IP. Defining low anterior resection syndrome: a systematic review of the literature. Colorectal Dis 2017; 19: 713-22.

Bryant CL, Lunniss PJ, Knowles CH, Thaha MA, Chan CL. Anterior resection syndrome. Lancet Oncol 2012;13: e403-8. (doi: 10.1016/S1470-2045(12)70236-X).

Ridolfi TJ, Berger N, Ludwig KA. Low anterior resection syndrome: current management and future directions. Clin Colon Rectal Surg 2016; 29: 239-45.

Emmertsen KJ, Laurberg S. Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg 2012; 255: 922-8.

Martellucci J. Low anterior resection syndrome: a treatment algorithm. Dis Colon Rectum 2016; 59: 79-82.

Chen TY-T, Emmertsen KJ, Laurberg S. What Are the best questionnaires to capture anorectal function after surgery in rectal cancer? Curr Colorectal Cancer Rep 2015; 11: 37-43.

Ekkarat P, Boonpipattanapong T, Tantiphlachiva K, Sangkhathat S. Factors determining low anterior resection syndrome after rectal cancer resection: a study in Thai patients. Asian J Surg 2016; 39: 225-31.

Chen TY, Wiltink LM, Nout RA, et al. Bowel function 14 years after preoperative short-course radiotherapy and total mesorectal excision for rectal cancer: report of a multicenter randomized trial. Clin Colorectal Cancer 2015; 14: 106-14.

Jimenez-Gomez LM, Espin-Basany E, et al. Factors associated with low anterior resection syndrome after surgical treatment of rectal cancer. Colorectal Dis 2018; 20: 195-200.

Chen TY, Emmertsen KJ, Laurberg S. Bowel dysfunction after rectal cancer treatment: a study comparing the specialist's versus patient's perspective. BMJ Open 2014; 4: e003374. (doi: 10.1136/bmjopen-2013-003374).

Bjoern MX, Nielsen S, Perdawood SK. Quality of life after surgery for rectal cancer: a comparison of functional outcomes after transanal and laparoscopic approaches. J Gastrointest Surg 2019; 23: 1623-30.

Sturiale A, Martellucci J, Zurli L, et al. Long-term functional follow-up after anterior rectal resection for cancer. Int J Colorectal Dis 2017; 32: 83-8.

Objavljeno
2020/04/15
Rubrika
Originalni naučni članak