Patient reported and physician recorded bowel dysfunction following colorectal resection and radical cystectomy: a prospective, comparative study

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dc.contributor.authorNg, K.-S.
dc.contributor.authorGladman, M.A.
dc.date.issued2020
dc.description.abstractAIM: Bowel dysfunction following anterior resection (AR) is termed 'low anterior resection syndrome (LARS)'. It is unclear whether such dysfunction occurs following other bowel/pelvic operations as well. This study aimed to characterise and compare bowel dysfunction following AR, right hemicolectomy (RH) and radical cystectomy (RC). METHOD: A prospective study of consecutive patients undergoing AR, RH, and RC (2002-2012) was performed at a tertiary referral centre in Sydney, Australia. Outcome measures included: (i) patient-reported (satisfaction with bowel function, self-described bowel function, and self-reported change in bowel function); (ii) objective assessment of bowel function using validated criteria to identify symptoms and stratify patients into those with constipation and/or faecal incontinence (FI); and (iii) health-related quality of life (SF-36v2). RESULTS: Of 743 eligible patients, 70% participated (AR: n=338, mean age 69.6yrs [SD11.9], 59% male; RH: n=150, 75.8yrs [SD10.5], 54% male; RC: n=34, 71.1yrs [SD14.1], 71% male). AR patients were three times more likely to report change in bowel function post-surgery, and self-judged their bowel function as 'abnormal' more frequently (64%) than following RH (35%) and RC (35%) (P<0.01). AR patients were four times more likely to meet criteria for concomitant constipation and FI. Patients with concomitant constipation and FI had lower physical and mental SF-36v2 scores (P<0.001). CONCLUSION: Bowel dysfunction occurred after RH and RC but rates were higher following AR. This suggests that LARS occurs due to a direct impact of partial/complete loss of the rectum rather than just due to loss of bowel length and/or the consequence(s) of pelvic dissection.
dc.description.statementofresponsibilityKheng-Seong Ng, Marc A Gladman
dc.identifier.citationColorectal Disease, 2020; 22(10):1336-1347
dc.identifier.doi10.1111/codi.15041
dc.identifier.issn1462-8910
dc.identifier.issn1463-1318
dc.identifier.orcidGladman, M.A. [0000-0001-8412-9570]
dc.identifier.urihttp://hdl.handle.net/2440/123961
dc.language.isoen
dc.publisherWiley
dc.relation.grantNHMRC
dc.rightsThis article is protected by copyright. All rights reserved [Wiley]
dc.source.urihttps://doi.org/10.1111/codi.15041
dc.subjectHumans
dc.subjectRectal Neoplasms
dc.subjectSyndrome
dc.subjectPostoperative Complications
dc.subjectColectomy
dc.subjectCystectomy
dc.subjectProspective Studies
dc.subjectQuality of Life
dc.subjectAged
dc.subjectPhysicians
dc.subjectFemale
dc.subjectMale
dc.subjectPatient Reported Outcome Measures
dc.titlePatient reported and physician recorded bowel dysfunction following colorectal resection and radical cystectomy: a prospective, comparative study
dc.typeJournal article
pubs.publication-statusPublished

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