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. 2015 Feb;31(1):23-8.
doi: 10.3393/ac.2015.31.1.23. Epub 2015 Feb 28.

Predictors of fecal incontinence and related quality of life after a total mesorectal excision with primary anastomosis for patients with rectal cancer

Marieke S Walma  1 , Verena N N Kornmann  1 , Djamila Boerma  1 , Marnix A J de Roos  2 , Henderik L van Westreenen  1
Affiliations

Predictors of fecal incontinence and related quality of life after a total mesorectal excision with primary anastomosis for patients with rectal cancer

Marieke S Walma et al. Ann Coloproctol. 2015 Feb.

Erratum in

  • Erratum.
    Walma MS, Kornmann VN, Boerma D, de Roos MA, van Westreenen HL. Walma MS, et al. Ann Coloproctol. 2015 Aug;31(4):167. doi: 10.3393/ac.2015.31.4.167. Ann Coloproctol. 2015. PMID: 26361621 Free PMC article.

Abstract

Purpose: After total mesorectal excision (TME) with primary anastomosis for patients with rectal cancer, the quality of life (QoL) may be decreased due to fecal incontinence. This study aimed to identify predictors of fecal incontinence and related QoL.

Methods: Patients who underwent TME with primary anastomosis for rectal cancer between December 2008 and June 2012 completed the fecal incontinence quality of life scale (FIQoL) and Wexner incontinence score. Factors associated with these scores were identified using a linear regression analysis.

Results: A total of 80 patients were included. Multivariate analysis identified a diverting ileostomy (n = 58) as an independent predictor of an unfavorable outcome on the FIQoL subscale coping/behavior (P = 0.041). Ileostomy closure within and after 3 months resulted in median Wexner scores of 5.0 (interquartile range [IQR], 2.5-8.0) and 10.5 (IQR, 6.0-13.8), respectively (P < 0.001). The median FIQoL score was 15.0 (IQR, 13.1-16.0) for stoma closure within 3 months versus 12.0 (IQR, 10.5-13.9) for closure after 3 months (P = 0.001).

Conclusion: A diverting ileostomy is a predictor for an impaired FIQoL after a TME for rectal cancer. Stoma reversal within 3 months showed better outcomes than reversal after 3 months. Patients with a diverting ileostomy should be informed about the impaired QoL, even after stoma closure.

Keywords: Fecal incontinence; Ileostomy; Quality of life; Rectal neoplasms.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

References

    1. Lange MM, Rutten HJ, van de Velde CJ. One hundred years of curative surgery for rectal cancer: 1908-2008. Eur J Surg Oncol. 2009;35:456–463. - PubMed
    1. Di Betta E, D'Hoore A, Filez L, Penninckx F. Sphincter saving rectum resection is the standard procedure for low rectal cancer. Int J Colorectal Dis. 2003;18:463–469. - PubMed
    1. Bryant CL, Lunniss PJ, Knowles CH, Thaha MA, Chan CL. Anterior resection syndrome. Lancet Oncol. 2012;13:e403–e408. - PubMed
    1. Cornish JA, Tilney HS, Heriot AG, Lavery IC, Fazio VW, Tekkis PP. A meta-analysis of quality of life for abdominoperineal excision of rectum versus anterior resection for rectal cancer. Ann Surg Oncol. 2007;14:2056–2068. - PubMed
    1. Pachler J, Wille-Jorgensen P. Quality of life after rectal resection for cancer, with or without permanent colostomy. Cochrane Database Syst Rev. 2005;(2):CD004323. - PubMed

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