Skip to main content

Advertisement

SpringerLink
Log in

Late pelvic function following rectal cancer resection – a case-control study

  • Original Article
  • Published:
European Surgery Aims and scope Submit manuscript

Summary

BACKGROUND: There are still controversial data about the impact of rectal resection for malignancies on overall pelvic organ function and quality of life. Our aim was to investigate whether these parameters differ compared to the general population without bowel resection. METHODS: One hundred eighteen patients (44%) operated for rectal cancer at a single institution between 1995 and 2005 completed a self-administering questionnaire including the International Index of Erectile Function, Female Sexual Function Index, Short Form-12 Health Survey, International Prostatic Symptom Score, International Consultation on Incontinence Questionnaire-Short Form, and Vaizey Incontinence Score. Healthy subjects with no bowel resection served as controls for each case and were matched by age (±5 years) and gender. The median follow-up time was 7 years (range 2.8–14.2). RESULTS: The Vaizey incontinence score was significant higher in the patient group compared with the control group (patients: median 4 (range 0–24), controls: 0 (range 0–20); p<0.0001). Sexual and urinary function showed no significant difference between both groups. In regard to the SF-12 health survey the median physical health score of patients was 51.5 (range 22.0–58.2) compared to 53.6 (range 16.8–64.3) of the control subjects (p = 0.1241). The median mental health score of the patient group was 55.1 (range 19.1–63.8) compared to 55.0 (range 28.7–63.8) of the control group (p = 0.2222). CONCLUSIONS: Patients with rectal cancer resection have a significant impairment of fecal continence. Notably, urinary and sexual function and quality of life are comparable with healthy subjects without colorectal resection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Roblick UJ, Bader FG, Jungbluth T, Laubert T, Bouchard R, Bruch H-P. Laparoscopic resection for rectal cancer. European Surgery 2010;42:276–82

    Article  Google Scholar 

  • Ammann K, Kirchmayr W, Klaus A, Muhlmann G, Kafka R, Oberwalder M, De Vries A, Ofner D, Weiss H. Impact of neoadjuvant chemoradiation on anal sphincter function in patients with carcinoma of the midrectum and low rectum. Arch Surg 2003;138:257–61

    Article  PubMed  Google Scholar 

  • Canda AE, Terzi C, Gorken IB, Oztop I, Sokmen S, Fuzun M. Effects of preoperative chemoradiotherapy on anal sphincter functions and quality of life in rectal cancer patients. Int J Colorectal Dis 2010;25:197–204

    Article  PubMed  Google Scholar 

  • Lundby L, Krogh K, Jensen VJ, Gandrup P, Qvist N, Overgaard J, Laurberg S. Long-term anorectal dysfunction after postoperative radiotherapy for rectal cancer. Dis Colon Rectum 2005;48:1343–9; discussion 1349–52; author reply 1352

    Article  PubMed  Google Scholar 

  • Nesbakken A, Nygaard K, Lunde OC. Outcome and late functional results after anastomotic leakage following mesorectal excision for rectal cancer. Br J Surg 2001;88:400–4

    Article  PubMed  CAS  Google Scholar 

  • Riss S, Stremitzer S, Riss K, Mittlbock M, Bergmann M, Stift A. Pelvic organ function and quality of life after anastomotic leakage following rectal cancer surgery. Wien Klin Wochenschr 2011;123:53–7

    Article  PubMed  Google Scholar 

  • Brown CJ, Fenech DS, McLeod RS. Reconstructive techniques after rectal resection for rectal cancer. Cochrane Database Syst Rev 2008;2:CD006040

    PubMed  Google Scholar 

  • Heald RJ, Moran BJ, Ryall RD, Sexton R, MacFarlane JK. Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978–1997. Arch Surg 1998;133:894–9

    Article  PubMed  CAS  Google Scholar 

  • Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996;34:220–33

    Article  PubMed  Google Scholar 

  • Barry MJ, Fowler FJ Jr, O'Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, Cockett AT. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 1992;148:1549–57; discussion 1564

    PubMed  CAS  Google Scholar 

  • Twiss CO, Fischer MC, Nitti VW. Comparison between reduction in 24-hour pad weight, International Consultation on Incontinence-Short Form (ICIQ-SF) score, International Prostate Symptom Score (IPSS), and Post-Operative Patient Global Impression of Improvement (PGI-I) score in patient evaluation after male perineal sling. Neurourol Urodyn 2007;26:8–13

    Article  PubMed  Google Scholar 

  • Vaizey CJ, Carapeti E, Cahill JA, Kamm MA. Prospective comparison of faecal incontinence grading systems. Gut 1999;44:77–80

    Article  PubMed  CAS  Google Scholar 

  • Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D'Agostino R Jr. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191–208

    Article  PubMed  CAS  Google Scholar 

  • Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997;49:822–30

    Article  PubMed  CAS  Google Scholar 

  • Bullinger M, Kirchberger I. SF-36. Fragebogen zum Gesundheitszustand. Handanweisung. Göttingen Hogrefe-Verlag GmbH & Co. KG, 1998

  • Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187–96

    Article  PubMed  Google Scholar 

  • Lange MM, den Dulk M, Bossema ER, Maas CP, Peeters KC, Rutten HJ, Klein Kranenbarg E, Marijnen CA, van de Velde CJ. Risk factors for faecal incontinence after rectal cancer treatment. Br J Surg 2007;94:1278–84

    Article  PubMed  CAS  Google Scholar 

  • Pietsch AP, Fietkau R, Klautke G, Foitzik T, Klar E. Effect of neoadjuvant chemoradiation on postoperative fecal continence and anal sphincter function in rectal cancer patients. Int J Colorectal Dis 2007;22:1311–7

    Article  PubMed  Google Scholar 

  • Pretlove SJ, Radley S, Toozs-Hobson PM, Thompson PJ, Coomarasamy A, Khan KS. Prevalence of anal incontinence according to age and gender: a systematic review and meta-regression analysis. Int Urogynecol J Pelvic Floor Dysfunct 2006;17:407–17

    Article  PubMed  CAS  Google Scholar 

  • de Miguel M, Oteiza F, Ciga MA, Armendariz P, Marzo J, Ortiz H. Sacral nerve stimulation for the treatment of faecal incontinence following low anterior resection for rectal cancer. Colorectal Dis 2011;13:72–7

    Article  PubMed  CAS  Google Scholar 

  • Ho VP, Lee Y, Stein SL, Temple LK. Sexual function after treatment for rectal cancer: a review. Dis Colon Rectum 2011;54:113–25

    Article  PubMed  Google Scholar 

  • Yang L, Yu YY, Zhou ZG, Li Y, Xu B, Song JM, Liu HY, Jiang X. Quality of life outcomes following laparoscopic total mesorectal excision for low rectal cancers: a clinical control study. Eur J Surg Oncol 2007;33:575–9

    Article  PubMed  CAS  Google Scholar 

  • Varpe P, Huhtinen H, Rantala A, Salminen P, Rautava P, Hurme S, Gronroos J. Quality of life after surgery for rectal cancer with special reference to pelvic floor dysfunction. Colorectal Dis 2011;13:399–405

    Article  PubMed  CAS  Google Scholar 

  • Barisic G, Markovic V, Popovic M, Dimitrijevic I, Gavrilovic P, Krivokapic Z. Function after intersphincteric resection for low rectal cancer and its influence on quality of life. Colorectal Dis 2011;13:638–43

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Medical University of Vienna, Vienna, Austria

    S. Riss, H. Franner, M. Riedl, B. Teleky & Anton Stift

  2. Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria

    M. Mittlböck

  3. Department of Surgery, Hospital Barmherzige Brüder Wien, Vienna, Austria

    F. Herbst

Authors
  1. S. Riss
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Franner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Mittlböck
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Riedl
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Herbst
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B. Teleky
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anton Stift
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Riss.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Riss, S., Franner, H., Mittlböck, M. et al. Late pelvic function following rectal cancer resection – a case-control study. Eur Surg 44, 41–46 (2012). https://doi.org/10.1007/s10353-011-0036-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10353-011-0036-9

Keywords

Search

Navigation