Abstract
Background and aims
This study aims to evaluate the therapeutic effect of retrograde colonic irrigation in patients with faecal incontinence after a low anterior resection for a rectal carcinoma.
Materials and Methods
Patients with a previous low anterior resection, who were selected for treatment with retrograde colonic irrigation for faecal incontinence between 2005 and 2008, were included in the study. The data from the patients were gathered by chart research and an interview by phone.
Results
Thirty patients were included in the study. Three patients died and one patient was not able to answer questions due to a cognitive disorder. The data of the remaining 26 patients were analysed. Five patients had already stopped with the retrograde colonic irrigation treatment due to side effects. Twelve of the 21 patients (57.46%) who still performed RCI became completely (pseudo)continent, three patients (14.2%) were incontinent for flatus and six patients (29.4%) were still incontinent for liquid stool. Five patients stopped with the retrograde colonic irrigation treatment due to side-effects.
Conclusion
Retrograde colonic irrigation is an effective method to treat patients with faecal incontinence after a low anterior resection for rectal carcinoma. Retrograde colonic irrigation is not invasive and has only mild side effects.
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References
Kapiteijn E, Marijnen CA, Nagtegaal ID et al (2001) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 345:638–646
Sauer R, Fietkau R, Wittekind C et al (2003) Adjuvant vs. neoadjuvant radiochemotherapy for locally advanced rectal cancer: the German trial CAO/ARO/AIO-94. Colorectal Dis 5:406–415
Williams N, Seow-Choen F (1998) Physiological and functional outcome following ultra-low anterior resection with colon pouch-anal anastomosis. Br J Surg 85:1029–1035
Lange MM, den Dulk M, Bossema ER et al (2007) Risk factors for faecal incontinence after rectal cancer treatment. Br J Surg 94:1278–1284
Fichera A, Michelassi F (2001) Long-term prospective assessment of functional results after proctectomy with coloanal anastomosis. J Gastrointest Surg 5:153–157
Ratto C, Grillo E, Parello A et al (2005) Sacral neuromodulation in treatment of fecal incontinence following anterior resection and chemoradiation for rectal cancer. Dis Colon Rectum 48:1027–1036
Melenhorst J, Koch SM, Uludag O et al (2007) Sacral neuromodulation in patients with faecal incontinence: results of the first 100 permanent implantations. Colorectal Dis 9:725–730
Belyaev O, Muller C, Uhl W (2006) Neosphincter surgery for fecal incontinence: a critical and unbiased review of the relevant literature. Surg Today 36:295–303
Tan EK, Vaizey C, Cornish J et al (2008) Surgical strategies for faecal incontinence—a decision analysis between dynamic graciloplasty, artificial bowel sphincter and end stoma. Colorectal Dis 10:577–586
Gosselink MP, Darby M, Zimmerman DD et al (2005) Long-term follow-up of retrograde colonic irrigation for defaecation disturbances. Colorectal Dis 7:65–69
Iwama T, Imajo M, Yaegashi K et al (1989) Self washout method for defecational complaints following low anterior rectal resection. Jpn J Surg 19:251–253
Koch SM, Melenhorst J, van Gemert WG et al (2008) Prospective study of colonic irrigation for the treatment of defaecation disorders. Br J Surg 95:1273–1279
Koch SM, Uludag O, El Naggar K et al (2008) Colonic irrigation for defecation disorders after dynamic graciloplasty. Int J Colorectal Dis 23:195–200
Williams NS, Patel J, George BD et al (1991) Development of an electrically stimulated neoanal sphincter. Lancet 338:1166–1169
Crowell MD, Schettler VA, Lacy BE et al (2007) Impact of anal incontinence on psychosocial function and health-related quality of life. Dig Dis Sci 52:1627–1631
Pietsch AP, Fietkau R, Klautke G et al (2007) Effect of neoadjuvant chemoradiation on postoperative fecal continence and anal sphincter function in rectal cancer patients. Int J Colorectal Dis 22:1311–1317
Binkley GE (1952) Construction and care of abdominal colostomy. Am J Surg 83:807–811
Pucciani F, Ringressi MN, Redditi S et al (2008) Rehabilitation of fecal incontinence after sphincter-saving surgery for rectal cancer: encouraging results. Dis Colon Rectum 48:2094–2099
Jarrett ME, Matzel KE, Stosser M et al (2005) Sacral nerve stimulation for faecal incontinence following a rectosigmoid resection for colorectal cancer. Int J Colorectal Dis 20:446–451
Holzer B, Rosen HR, Zaglmaier W et al (2008) Sacral nerve stimulation in patients after rectal resection-preliminary report. J Gastrointest Surg 12:921–925
Matzel KE, Stadelmaier U, Bittorf B et al (2002) Bilateral sacral spinal nerve stimulation for fecal incontinence after low anterior rectum resection. Int J Colorectal Dis 17:430–434
Geerdes BP, Zoetmulder FA, Baeten CG (1995) Double dynamic graciloplasty and coloperineal pull-through after abdominoperineal resection. Eur J Cancer 31A:1248–1252
Baeten CG, Konsten J, Heineman E et al (1994) Dynamic graciloplasty for anal atresia. J Pediatr Surg 29:922–924 discussion 925
Brown CJ, Fenech DS, McLeod RS (2008) Reconstructive techniques after rectal resection for rectal cancer. Cochrane Database Syst Rev (2):CD006040.
O’Bichere A, Sibbons P, Dore C et al (2000) Experimental study of faecal continence and colostomy irrigation. Br J Surg 87:902–908
Malone PS, Ransley PG, Kiely EM (1990) Preliminary report: the antegrade continence enema. Lancet 336:1217–1218
Rongen MJ, van der Hoop AG, Baeten CG (2001) Cecal access for antegrade colon enemas in medically refractory slow-transit constipation: a prospective study. Dis Colon Rectum 44:1644–1649
Renner K, Rosen HR, Novi G et al (1999) Quality of life after surgery for rectal cancer: do we still need a permanent colostomy? Dis Colon Rectum 42:1160–1167
Sprangers MA, Taal BG, Aaronson NK et al (1995) Quality of life in colorectal cancer. Stoma vs. nonstoma patients. Dis Colon Rectum 38:361–369
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Koch, S.M.P., Rietveld, M.P., Govaert, B. et al. Retrograde colonic irrigation for faecal incontinence after low anterior resection. Int J Colorectal Dis 24, 1019–1022 (2009). https://doi.org/10.1007/s00384-009-0719-x
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DOI: https://doi.org/10.1007/s00384-009-0719-x