Annals of Coloproctology

Original Articles

Validation of the Vietnamese version of the low anterior resection syndrome score questionnaire: Tuong-Anh Mai-Phan, Vu Quang Pham; Received July 24, 2022 Accepted August 26, 2022 Published online November 25, 2022; DOI: https://doi.org/10.3393/ac.2022.00514.0073 [Epub ahead of print]

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Purpose
The aim of this study was to validate the low anterior resection syndrome (LARS) score questionnaire in the Vietnamese language among Vietnamese patients who underwent sphincter-preserving surgery for rectal cancer.
Methods
The LARS score questionnaire was translated from English into Vietnamese and then back-translated as recommended internationally. From January 2018 to December 2020, 93 patients who underwent sphincter-preserving surgery completed the Vietnamese version of the LARS score questionnaire together with an anchored question assessing the influence of bowel function on quality of life. To validate test-retest reliability, patients were requested to answer the LARS score questionnaire twice.
Results
Ninety-three patients completed the LARS score questionnaire, of whom 89 responded twice. The patients who responded twice were included in the analysis of test-retest reliability. Fifty-eight patients had a “major” LARS score. The LARS score was able to discriminate between patients who were obese and those who were not (P<0.001) and between the LAR and AR procedures (P<0.001). Age and sex were not associated with higher LARS scores (P=0.975). There was a perfect fit between the quality of life category question and the LARS score in 56.2% of cases, and a moderate fit was found in 42.7% of cases, showing reasonable convergent validity. The test-retest reliability of 89 patients showed a high intraclass correlation coefficient.
Conclusion
The Vietnamese version of the LARS score questionnaire is a valid tool for measuring LARS.

Citations

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Major Low Anterior Resection Syndrome (LARS) and Quality of Life in Patients With Low Rectal Cancer: A Preoperative Survey Using LARS Score and European Organisation for Research and Treatment of Cancer’s 30-Item Core Quality of Life Questionnaire
Ly Huu Phu, Ho Tat Bang, Nguyen Viet Binh, Hoang Danh Tan, Ung Van Viet, Nguyen Trung Tin
Cureus.2023;[Epub] CrossRef

Annual long-term functional outcomes after transanal repair for symptomatic rectocele: Akira Tsunoda, Hiroshi Kusanagi; Received April 22, 2022 Accepted July 7, 2022 Published online November 15, 2022; DOI: https://doi.org/10.3393/ac.2022.00283.0040 [Epub ahead of print]

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Abstract PDF

Purpose
This study was performed to assess the long-term annual functional outcomes and quality of life (QOL) after transanal rectocele repair.
Methods
We evaluated retrospectively collected data from patients who underwent transanal repair for symptomatic rectocele between February 2012 and December 2018. The Constipation Scoring System (CSS), the Fecal Incontinence Severity Index (FISI), and several QOL questionnaires (e.g., the Patient Assessment of Constipation-QOL [PAC-QOL], Fecal Incontinence QOL, and the 36-Item Short Form Survey [SF-36]) were administered before surgery and annually after surgery. Additionally, physiological assessments and defecography were performed before and after surgery. Substantial symptom improvement, indicated by at least a 50% reduction in the CSS or FISI score, was evaluated postoperatively. All postoperative follow-up results were compared with the preoperative data.
Results
Thirty-two patients were included in the study. The median follow-up period was 5 years (range, 0.5−7 years). Postoperative defecography showed that the rectocele size significantly decreased (P<0.0001). However, the physiological assessment did not reveal postoperative changes. The CSS score 1 year after surgery was significantly lower than the preoperative score (P<0.0001) and remained significantly low until the long-term follow-up. Constipation improved by more than 80% 2 to 5 years postoperatively, and fecal incontinence improved in 2/3 of the patients after 5 years. The PAC-QOL scores significantly improved (all P<0.05) over time until the 3-year and long-term follow-ups, and 6 of the 8 SF-36 scores significantly improved at specific points postoperatively.
Conclusion
Transanal rectocele repair provides long-term improvement for constipation and constipation-specific QOL.

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Laparoscopic or transanal repair of rectocele? Comparison of a reduction in rectocele size
Akira Tsunoda, Tomoko Takahashi, Satoshi Matsuda, Hiroshi Kusanagi
International Journal of Colorectal Disease.2023;[Epub] CrossRef

Anorectal physiology & pelvic floor disorder

Does transanal endoscopic microsurgery affect rectal function?: Evgeniy Khomyakov, Stanislav Chernyshov, Oksana Fomenko, Evgeny Rybakov; Ann Coloproctol. 2023;39(4):326-331. Published online November 14, 2022; DOI: https://doi.org/10.3393/ac.2022.00220.0031

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Abstract PDF: Purpose
Transanal endoscopic microsurgery (TEM) is the most standardized method for the local excision of rectal neoplasms. Unfortunately, local excisions of rectal lesions by means of TEM are not completely free from undesirable functional sequela. This study was performed to evaluate the risk factors of major loss of function after TEM.
Methods
Eighty-nine patients underwent TEM between 2019 and 2020. Anorectal manometry was performed before the surgery and 3, 6, and 12 months after the surgery. The quality of life (QoL) was assessed using the Fecal Incontinence Quality of Life scale.
Results
The major decrease in QoL was observed in women in 3 months after the surgery in terms of lifestyle and frustration domains (3.6 and 3.64 points, respectively). In 3 months after the surgery, there was a significant decrease in resting pressure both in male and female patients (P=0.01). This difference remained significant 6 months after the surgery (P=0.01). In 12 months after the surgery, resting pressure returned to the preoperative level in most patients (P=0.50). A significant decrease in manometric parameters appeared when the surgery time is more than 55 minutes (P=0.05), the tumor localization is lower than 3 cm from the anus (P=0.03), and the tumor size is over 3 cm (P=0.001).
Conclusion
The most significant risk factors for the development of functional disorders after TEM are surgery time of >55 minutes, tumor localization at <3 cm from the anal verge, and tumor size of >3 cm.

Anorectal benign disease

What can patients expect in the long term from radiofrequency thermocoagulation of hemorrhoids on bleeding, prolapse, quality of life, and recurrence: “no pain, no gain” or “no pain but a gain”?: Jean-Michel Didelot, Benjamin Raux, Romain Didelot, Franz Rudler, Aurelien Mulliez, Anthony Buisson, Armando Abergel, Pierre Blanc; Ann Coloproctol. 2024;40(5):481-489. Published online October 11, 2022; DOI: https://doi.org/10.3393/ac.2022.00311.0044

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Abstract PDF

Purpose
The purpose of this study was to assess the long-term efficacy of hemorrhoidal radiofrequency thermocoagulation (RFT) on bleeding, prolapse, quality of life (QoL), and recurrence.
Methods
This retrospective, single-center study, with RFT performed using procedure modified via hemorrhoid exteriorization assessed the evolution of hemorrhoidal prolapse rated by Goligher scale; bleeding and discomfort (0–10), feeling of improvement and satisfaction (–5 to +5/5) by analog scales; the impact of hemorrhoids on QoL by HEMO-FISS-QoL score.
Results
From April 2016 to January 2021, 124 patients underwent surgery and 107 were interviewed in September 2021. The average follow-up was 30 months (range, 8–62 months). The mean work stoppage was 3 days, none in 71.0% of the cases. A mean of 4,334 J was applied. No analgesics were required for 66.4% of patients. External hemorrhoidal thrombosis was the only immediate complication in 9 patients, with no long-term reported complication. Bleeding disappeared in 53 out of 102 patients or dropped from 7 to 3 out of 10 (P<0.001). Prolapse reduced from mean grade 3 to 2 (P<0.001), discomfort from 7 to 2 out of 10 (P<0.001). HEMO-FISS-QoL score improved from 22 to 7 out of 100 (P<0.001). Feeling of improvement and overall satisfaction rate were +4/5. Recurrence occurred in 21.5% of patients at 22 months, and 6 required reoperation. Of the patients, 91.6% would choose the same procedure again and 96.3% recommend it.
Conclusion
RFT, although imperfect, leads to a significant improvement in hemorrhoidal symptoms and a lasting increase in QoL with minimal pain and downtime, high acceptance, and low complication and recurrence rates.

Citations

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Quand et comment traiter des hémorroïdes
Thierry Higuero
La Presse Médicale Formation.2024; 5(1): 24. CrossRef
The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease
Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Luigi Brusciano, Luigi Marano, Maurizio Grillo, Mauro Natale Maglio, Fabrizio Foroni, Alessio Palumbo, Maria Laura Sandoval Sotelo, Luciano Vicenzo, Michele Lanza, Giovanna Frezza, Massimo Antropoli, Cl
Annals of Coloproctology.2024; 40(4): 287. CrossRef

Colorectal cancer

Outcomes following anastomotic leak from rectal resections, including bowel function and quality of life: Angelina Di Re, Salam Tooza, Jason Diab, Charbel Karam, Mina Sarofim, Kevin Ooi, Catherine Turner, Daniel Kozman, David Blomberg, Matthew Morgan; Ann Coloproctol. 2023;39(5):395-401. Published online April 14, 2022; DOI: https://doi.org/10.3393/ac.2022.00073.0010

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Abstract PDF

Purpose
Anastomotic leak (AL) is an uncommon but potentially devastating complication after rectal resection. We aim to provide an updated assessment of bowel function and quality of life after AL, as well as associated short- and long-term outcomes.
Methods
A retrospective audit of all rectal resections performed at a colorectal unit and associated private hospitals over the past 10 years was performed. Relevant demographic, operative, and histopathological data were collected. A prospective survey was performed regarding patients’ quality of life and fecal continence. These patients were matched with nonAL patients who completed the same survey.
Results
One hundred patients (out of 1,394 resections) were included. AL was contained in 66.0%, not contained in 10.0%, and only anastomotic stricture in 24.0%. Management was antibiotics only in 39.0%, percutaneous drainage in 9.0%, operative abdominal drainage in 19.0%, transrectal drainage in 6.0%, combination of percutaneous drainage and transrectal drainage in 2.0%, and combination abdominal/transrectal drainage in 1.0%. The 1-year stoma rate was 15.0%. Overall, mean Fecal Incontinence Severity Instrument scores were higher for AL patients than their matched counterparts (8.06±10.5 vs. 2.92±4.92, P=0.002). Patients with an AL had a mean EuroQol visual analogue scale (EQ-VAS) of 76.23±19.85; this was lower than the matched mean EQ-VAS for non-AL patients of 81.64±18.07, although not statistically significant (P=0.180).
Conclusion
The majority of AL patients in this study were managed with antibiotics only. AL was associated with higher fecal incontinence scores in the long-term; however, this did not equate to lower quality of life scores.

Citations

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The Effect of Post‐Treatment Combined Lifestyle Interventions on Quality of Life in Colorectal Cancer Patients – A Systematic Review
Anke H. C. Gielen, Britt J. M. Thomassen, Tim J. Bult, Jarno Melenhorst, Merel L. Kimman, Stephanie O. Breukink
Lifestyle Medicine.2024;[Epub] CrossRef
Serum nutritional predictive biomarkers and risk assessment for anastomotic leakage after laparoscopic surgery in rectal cancer patients
Paerhati Shayimu, Maitisaidi Awula, Chang-Yong Wang, Rexida Jiapaer, Yi-Peng Pan, Zhi-Min Wu, Yi Chen, Ze-Liang Zhao
World Journal of Gastrointestinal Surgery.2024; 16(10): 3142. CrossRef
Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
Gyung Mo Son
Annals of Coloproctology.2024; 40(5): 415. CrossRef
Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery
Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
Medicina.2024; 60(12): 1966. CrossRef

Colorectal cancer

Outcomes of side-to-end versus end-to-end colorectal anastomosis in nonemergent sigmoid and rectal cancers: a randomized controlled clinical trial: Tamer A.A.M. Habeeb, Hatem Mohammad, Tamer Wasefy, Mohamed Ibrahim Mansour; Ann Coloproctol. 2023;39(3):231-241. Published online March 11, 2022; DOI: https://doi.org/10.3393/ac.2021.00906.0129

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Graphical Abstract Abstract PDF

Purpose
The outcomes of open colorectal anastomosis of side-to-end versus end-to-end in nonemergent sigmoid and rectal cancer surgery in adults were compared.
Methods
A randomized controlled trial on individuals with sigmoid and rectal cancers was conducted between September 2016 and September 2018.
Results
The mean age was 62.58±12.3 years in the side-to-end anastomotic (SEA) group and 61.03±13.98 years in the end-to-end anastomotic (EEA) group. Except for the operative time, intraoperative data revealed no significant differences between the studied groups, and the SEA group revealed that the mean anastomotic time was significantly shorter. Perioperative blood loss, length of stay, reoperation, inpatient death, infection, and bleeding were significantly associated with leakage. There is a statistically significant change regarding the range of bowel frequency in the EEA group only (P=0.04). There is a statistically significant difference regarding incontinence for flatus in the SEA group only (P≤0.001). A statistically significant change in both groups regards incontinence for liquid stools (P≤0.001) and clustering of stools (P≤0.001 and P=0.043). The quality of life in the SEA group significantly dropped at 6 months and then returned to baseline as regards to physical well-being (PWB), functional well-being (FWB), and colorectal cancer symptoms (CCS) with no difference as regards SWB and EWB, while in the EEA group, the exact change happened only as regard PWB and FWB, but SWB and CCS percentage did not return to baseline.
Conclusion
The SEA group offers a safe alternative approach to the EEA group.

Citations

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Minimally invasive left colectomy with total intracorporeal anastomosis versus extracorporeal anastomosis. A single center cohort study. Stage 2b IDEAL framework for evaluating surgical innovation
Xavier Serra-Aracil, Irene Gómez-Torres, Andrea Torrecilla-Portoles, Anna Serracant-Barrera, Albert García-Nalda, Anna Pallisera-Lloveras
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
The impact of powered circular staplers on anastomotic leak in left-sided colorectal cancer surgeries
Hayoung Lee, Yong Sik Yoon, Young Il Kim, Eun Jung Park, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim
Surgical Endoscopy.2024; 38(10): 6111. CrossRef

Malignant disease, Rectal cancer,Colorectal cancer,Functional outcome,Surgical technique

Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands: Joost A.G. van der Heijden, Kelly G.H. van de Pas, Frank J.C. van den Broek, Francois M.H. van Dielen, Gerrit D. Slooter, Adriana J.G. Maaskant-Braat; Ann Coloproctol. 2022;38(1):28-35. Published online June 29, 2021; DOI: https://doi.org/10.3393/ac.2020.00773.0110

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Abstract PDF

Purpose
Transanal total mesorectal excision (TaTME) was developed to overcome surgical difficulties experienced in distal pelvic dissection. Concerns have been raised about potential worse postoperative functional outcomes after TaTME. Also, the oncological safety was questioned. This study aimed to describe the functional, surgical, oncological outcomes and quality of life (QoL) after TaTME.
Methods
All consecutive TaTME cases for rectal cancer without disseminated disease between December 2016 and April 2019 were included. The Wexner incontinence score, low anterior resection syndrome (LARS) score, fecal incontinence-related QoL, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-core questionnaire and 29-item module (EORTC QLQ-C30/CR29) were collected. Kaplan-Meier analysis was used to calculate local recurrence-free survival.
Results
Thirty patients were eligible for analysis of which 23 received questionnaires. Response rate was 74%. After a median follow-up of respectively 20.0 and 23.0 months for functional and oncological outcomes, the median (interquartile range) of Wexner incontinence and LARS scores were 9.0 (7.0–12.0) and 33.1 (25.0–39.0). Major LARS was present in 73.3%. Fecal incontinence, general and colorectal-specific QoL subdomains that are associated with poor bowel function scored in line with previously reported data. The 2-year actuarial cumulative local recurrence rate was 3.7% (95% confidence interval, 2.4%–5.0%).
Conclusion
TaTME may lead to significant functional impairments. Patients should receive preoperative counseling on this topic and be fully aware of the potential consequences of their treatment. Oncological data were in line with other short- to moderate-term data and did not show alarming results.

Citations

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Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Quality of life and functional outcomes after transanal total mesorectal excision for rectal cancer—results from the implementation period in Denmark
M. X. Bjoern, F. B. Clausen, M. Seiersen, O. Bulut, F. Bech-Knudsen, J. E. Jansen, I. Gögenur, M. F. Klein
International Journal of Colorectal Disease.2022; 37(9): 1997. CrossRef
Analgesic effect of structured anal skin care for perianal dermatitis after low anterior resection in the rectal cancer patients: prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial
Gyung Mo Son, In Young Lee, Mi Sook Yun, Jung-Hea Youn, Hong Min An, Kyung Hee Kim, Seung Mi Yeo, Bokyung Ku, Myeong Suk Kwon, Kun Hyung Kim
Annals of Surgical Treatment and Research.2022; 103(6): 360. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef

Benign GI diease,Benign diesease & IBD

Long-term evolution of continence and quality of life after sphincteroplasty for obstetric fecal incontinence: Vicente Pla-Martí, Jose Martín-Arévalo, Rosa Martí-Fernández, David Moro-Valdezate, Stephanie García-Botello, Alejandro Espí-Macías, Miguel Mínguez-Pérez, Maria Dolores Ruiz-Carmona, Jose Vicente Roig-Vila; Ann Coloproctol. 2022;38(1):13-19. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.09.16

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Abstract PDF

Purpose
This study was performed to evaluate the long-term evolution of continence and patient’s quality of life after surgical treatment for obstetric fecal incontinence.
Methods
A prospective longitudinal study was conducted including consecutive patients who underwent sphincteroplasty for severe obstetric fecal incontinence. The first phase analyzed changes in continence and impact on quality of life. The second phase studied the long-term evolution reevaluating the same group of patients 6 years later. Degree of fecal incontinence was calculated using the Cleveland Clinic Score (CCS). Quality of life assessment was carried out with the Fecal Incontinence Quality of Life scale.
Results
Thirty-five patients with median age of 55 years (range, 28 to 73 years) completed the study. Phase 1 results: after a postoperative follow-up of 30 months (4 to 132 months), CCS had improved significantly from a preoperative of 15.7 ± 3.1 to 6.1 ± 5.0 (P < 0.001). Phase 2 results: median follow-up in phase 2 was 110 months (76 to 204 months). The CCS lowered to 8.4 ± 4.9 (P = 0.04). There were no significant differences between phases 1 and 2 in terms of quality of life; lifestyle (3.47 ± 0.75 vs. 3.16 ±1.04), coping/behavior (3.13 ±0.83 vs. 2.80 ±1.09), depression/self-perception (3.65 ±0.80 vs. 3.32 ± 0.98), and embarrassment (3.32 ± 0.90 vs. 3.12 ± 1.00).
Conclusion
Sphincteroplasty offers good short-medium term outcomes in continence and quality of life for obstetric fecal incontinence treatment. Functional clinical results deteriorate over time but did not impact on patients’ quality of life.

Citations

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Baiona’s Consensus Statement for Fecal Incontinence. Spanish Association of Coloproctology
Javier Cerdán Miguel, Antonio Arroyo Sebastián, Antonio Codina Cazador, Fernando de la Portilla de Juan, Mario de Miguel Velasco, Alberto de San Ildefonso Pereira, Fernando Jiménez Escovar, Franco Marinello, Mónica Millán Scheiding, Arantxa Muñoz Duyos, M
Cirugía Española (English Edition).2024; 102(3): 158. CrossRef
Diagnostic tools for fecal incontinence: Scoring systems are the crucial first step
Peter Liptak, Martin Duricek, Peter Banovcin
World Journal of Gastroenterology.2024; 30(6): 516. CrossRef
Consenso Baiona sobre Incontinencia Fecal: Asociación Española de Coloproctología
Javier Cerdán Miguel, Antonio Arroyo Sebastián, Antonio Codina Cazador, Fernando de la Portilla de Juan, Mario de Miguel Velasco, Alberto de San Ildefonso Pereira, Fernando Jiménez Escovar, Franco Marinello, Mónica Millán Scheiding, Arantxa Muñoz Duyos, M
Cirugía Española.2024; 102(3): 158. CrossRef
How to Avoid Becoming a Risk Factor of Fecal Incontinence Due to OASIS—A Narrative Review
Nikodem Horst
Journal of Clinical Medicine.2024; 13(17): 5071. CrossRef
The American Society of Colon and Rectal Surgeons’ Clinical Practice Guidelines for the Management of Fecal Incontinence
Liliana G Bordeianou, Amy J. Thorsen, Deborah S Keller, Alexander T. Hawkins, Craig Messick, Lucia Oliveira, Daniel L. Feingold, Amy L. Lightner, Ian M Paquette
Diseases of the Colon & Rectum.2023;[Epub] CrossRef
Validation of the Turkish version of the Quality of Life in Patients with Anal Fistula Questionnaire
Mehmet Ali Koç, Kerem Özgü, Derya Gökmen, Mehmet Süha Sevinç, Şiyar Ersöz, Cihangir Akyol
Turkish Journal of Colorectal Disease.2023; 33(4): 124. CrossRef
A systematic review of translation and experimental studies on internal anal sphincter for fecal incontinence
Minsung Kim, Bo-Young Oh, Ji-Seon Lee, Dogeon Yoon, Wook Chun, Il Tae Son
Annals of Coloproctology.2022; 38(3): 183. CrossRef
Is It a Refractory Disease?- Fecal Incontinence; beyond Medication
Chungyeop Lee, Jong Lyul Lee
The Ewha Medical Journal.2022;[Epub] CrossRef

Malignant disease, Rectal cancer, Functional outcomes

Validation of Korean Version of Low Anterior Resection Syndrome Score Questionnaire: Chang Woo Kim, Woon Kyung Jeong, Gyung Mo Son, Ik Yong Kim, Ji Won Park, Seung-Yong Jeong, Kyu Joo Park, Suk-Hwan Lee; Ann Coloproctol. 2020;36(2):83-87. Published online February 11, 2020; DOI: https://doi.org/10.3393/ac.2019.08.01

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Abstract PDF

Purpose
Patients who undergo radical surgery for rectal cancer often experience low anterior resection syndrome (LARS). Symptoms of this syndrome include frequent bowel movements, gas incontinence, fecal incontinence, fragmentation, and urgency. The aim of this study was to investigate the convergent validity, discriminative validity, and reliability of the Korean version of the LARS score questionnaire.
Methods
The English LARS score questionnaire was translated into Korean using the forward-and-back translation method. A total of 146 patients who underwent radical surgery for rectal cancer answered the Korean version of the LARS score questionnaire including an anchor question assessing the impact of bowel function. Participants answered the questionnaire once more after 2 weeks.
Results
The Korean LARS score questionnaire showed high convergent validity in terms of high correlation between the LARS score and quality of life (perfect fit 55.5% vs. moderate fit 37.6% vs. no fit 6.8%, respectively; P < 0.001). The LARS score also showed good discriminative validity between groups of patients differing by sex (29 for males vs. 25 for females; P = 0.014), tumor level (29 for ≤8 cm vs. 24 for >8 cm; P = 0.021), and radiotherapy (32 for yes vs. 24 for no; P = 0.001). The LARS score also demonstrated high reliability at test-retest with no difference between scores at the first and second tests (intraclass correlation coefficient: Q1 = 0.932; Q2 = 0.909, Q3 = 0.944, Q4 = 0.931, and Q5 = 0.942; P < 0.001, respectively).
Conclusion
The Korean version of the LARS score questionnaire has proven to be a valid and reliable tool for measuring LARS in Korean patients with rectal cancer.

Citations

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Bowel dysfunction and lower urinary tract symptoms on quality of life after sphincter-preserving surgery for rectal cancer: A cross-sectional study
Hyekyung Kim, Hyedan Kim, Ok-Hee Cho
European Journal of Oncology Nursing.2024; 69: 102524. CrossRef
Effectiveness of personalized treatment stage-adjusted digital therapeutics in colorectal cancer: a randomized controlled trial
Inah Kim, Ji Young Lim, Sun Woo Kim, Dong Wook Shin, Hee Cheol Kim, Yoon Ah Park, Yoon Suk Lee, Jung-Myun Kwak, Seok Ho Kang, Ji Youl Lee, Ji Hye Hwang
BMC Cancer.2023;[Epub] CrossRef
Low anterior resection syndrome
Seung‐Bum Ryoo
Annals of Gastroenterological Surgery.2023; 7(5): 719. CrossRef
Total neoadjuvant therapy with short-course radiotherapy Versus long-course neoadjuvant chemoradiotherapy in Locally Advanced Rectal cancer, Korean trial (TV-LARK trial): study protocol of a multicentre randomized controlled trial
Min Jung Kim, Dae Won Lee, Hyun-Cheol Kang, Ji Won Park, Seung-Bum Ryoo, Sae-Won Han, Kyung Su Kim, Eui Kyu Chie, Jae Hwan Oh, Woon Kyung Jeong, Byoung Hyuck Kim, Eun Mi Nam, Seung-Yong Jeong
BMC Cancer.2023;[Epub] CrossRef
Validation of low anterior resection syndrome score in Brazil with Portuguese
Kelly C.L.R. Buzatti, Andy Petroianu, Søren Laurberg, Rodrigo G. Silva, Beatriz D.S. Rodrigues, Peter Christensen, Antonio Lacerda-Filho, Therese Juul
Annals of Coloproctology.2023; 39(5): 402. CrossRef
Preoperative sequential short-course radiation therapy and FOLFOX chemotherapy versus long-course chemoradiotherapy for locally advanced rectal cancer: a multicenter, randomized controlled trial (SOLAR trial)
Min Kyu Kang, Soo Yeun Park, Jun Seok Park, Hye Jin Kim, Jong Gwang Kim, Byung Woog Kang, Jin Ho Baek, Seung Hyun Cho, An Na Seo, Duck-Woo Kim, Jin Kim, Se Jin Baek, Ji Hoon Kim, Ji Yeon Kim, Gi Won Ha, Eun Jung Park, In Ja Park, Chang Hyun Kim, Hyun Kang
BMC Cancer.2023;[Epub] CrossRef
Clinical Implication of Lateral Pelvic Lymph Node Metastasis in Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy
In Ja Park
The Ewha Medical Journal.2022; 45(1): 3. CrossRef
Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management
Seung Mi Yeo, Gyung Mo Son
The Ewha Medical Journal.2022;[Epub] CrossRef
Validation of the Vietnamese version of the low anterior resection syndrome score questionnaire
Tuong-Anh Mai-Phan, Vu Quang Pham
Annals of Coloproctology.2022;[Epub] CrossRef
Analgesic effect of structured anal skin care for perianal dermatitis after low anterior resection in the rectal cancer patients: prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial
Gyung Mo Son, In Young Lee, Mi Sook Yun, Jung-Hea Youn, Hong Min An, Kyung Hee Kim, Seung Mi Yeo, Bokyung Ku, Myeong Suk Kwon, Kun Hyung Kim
Annals of Surgical Treatment and Research.2022; 103(6): 360. CrossRef
Two dominant patterns of low anterior resection syndrome and their effects on patients’ quality of life
Min Jung Kim, Ji Won Park, Mi Ae Lee, Han-Ki Lim, Yoon-Hye Kwon, Seung-Bum Ryoo, Kyu Joo Park, Seung-Yong Jeong
Scientific Reports.2021;[Epub] CrossRef
Anterior resection syndrome: a randomized clinical trial of a 5-HT3 receptor antagonist (ramosetron) in male patients with rectal cancer
S -B Ryoo, J W Park, D W Lee, M A Lee, Y -H Kwon, M J Kim, S H Moon, S -Y Jeong, K J Park
British Journal of Surgery.2021; 108(6): 644. CrossRef
The incidence and risk factors of low anterior resection syndrome (LARS) after sphincter-preserving surgery of rectal cancer: a systematic review and meta-analysis
Rui Sun, Ziyi Dai, Yin Zhang, Junyang Lu, Yuelun Zhang, Yi Xiao
Supportive Care in Cancer.2021; 29(12): 7249. CrossRef
Defining low anterior resection syndrome (LARS): Scoring tools and patient-reported outcomes
Dr Rebekka Troller, Dr Jeremy Meyer, Mr Justin Davies
Seminars in Colon and Rectal Surgery.2021; 32(4): 100847. CrossRef
The Effect of Anastomotic Leakage on the Incidence and Severity of Low Anterior Resection Syndrome in Patients Undergoing Proctectomy: A Propensity Score Matching Analysis
Sungjin Kim, Sung Il Kang, So Hyun Kim, Jae-Hwang Kim
Annals of Coloproctology.2021; 37(5): 281. CrossRef
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
Annals of Coloproctology.2021; 37(6): 351. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
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Review

Organ Preservation Strategies After Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: Ri Na Yoo, Hyung Jin Kim; Ann Coloproctol. 2019;35(2):53-64. Published online April 30, 2019; DOI: https://doi.org/10.3393/ac.2019.04.15.1

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Abstract PDF

Standard use of neoadjuvant chemoradiotherapy, total mesorectal excision, and postoperative adjuvant chemotherapy in locally advanced rectal cancer has tremendously improved oncologic outcomes over the past several decades. However, these improvements come with costs of significant morbidity and poor quality of life. Along with developments in imaging techniques, clinical experience and evidence have identified a certain subgroup of patients that have exceptionally good clinical outcomes while preserving quality of life. Driven by patient demand and interest in preserving quality of life, numerous organ preservation treatment strategies for managing rectal cancer are rapidly evolving. Herein, the flow of research in organ preservation strategies and counter arguments are discussed.

Citations

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Efficacy and safety of MR-guided adaptive simultaneous integrated boost radiotherapy to primary lesions and positive lymph nodes in the neoadjuvant treatment of locally advanced rectal cancer: a randomized controlled phase III trial
Haohua Wang, Xiang Zhang, Boyu Leng, Kunli Zhu, Shumei Jiang, Rui Feng, Xue Dou, Fang Shi, Lei Xu, Jinbo Yue
Radiation Oncology.2024;[Epub] CrossRef
Organ preservation for early rectal cancer using preoperative chemoradiotherapy
Gyung Mo Son
Annals of Coloproctology.2023; 39(3): 191. CrossRef
Komplette Response nach neoadjuvanter Therapie beim Rektumkarzinom: Implikationen für die Chirurgie
Carolin Kastner, Bernhard Petritsch, Joachim Reibetanz, Christoph-Thomas Germer, Armin Wiegering
Der Chirurg.2022; 93(2): 144. CrossRef
Evaluating the benefit of adjuvant chemotherapy in patients with ypT0–1 rectal cancer treated with preoperative chemoradiotherapy
Ye Won Jeon, In Ja Park, Jeong Eun Kim, Jin-Hong Park, Seok-Byung Lim, Chan Wook Kim, Yong Sik Yoon, Jong Lyul Lee, Chang Sik Yu, Jin Cheon Kim
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Lateral Pelvic Lymph Node Dissection After Neoadjuvant Chemoradiotherapy in Patients With Rectal Cancer: A Single-Center Experience and Literature Review
Min Chul Kim, Jae Hwan Oh
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The apparent diffusion coefficient is a useful biomarker in predicting treatment response in patients with locally advanced rectal cancer
Mayra Evelia Jiménez de los Santos, Juan Armando Reyes-Pérez, Rosa Martha Sandoval-Nava, José Luis Villalobos-Juárez, Yolanda Villaseñor-Navarro, Itzel Vela-Sarmiento, Isabel Sollozo-Dupont
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Original Articles

Quality of Life After a Low Anterior Resection for Rectal Cancer in Elderly Patients: Verena N.N. Kornmann, Marieke S. Walma, Marnix A.J. de Roos, Djamila Boerma, Henderik L. van Westreenen; Ann Coloproctol. 2016;32(1):27-32. Published online February 29, 2016; DOI: https://doi.org/10.3393/ac.2016.32.1.27

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Abstract PDF

Purpose

Fecal incontinence is a major concern, and its incidence increases with age. Quality of life may decrease due to fecal incontinence after both sphincter-saving surgery and a rectal resection with a permanent stoma. This study investigated quality of life, with regard to fecal incontinency, in elderly patients after rectal-cancer surgery.

Methods

All patients who underwent elective rectal surgery with anastomosis for rectal cancer between December 2008 and June 2012 at two Dutch hospitals were eligible for inclusion. The Wexner and the fecal incontinence quality of life (FIQoL) scores were collected. Young (<70 years of age) and elderly (≥70 years of age) patients were compared.

Results

Seventy-nine patients were included, of whom 19 were elderly patients (24.1%). All diverting stomas that had been placed (n = 60, 75.9%) had been closed at the time of the study. There were no differences in Wexner or FIQoL scores between the young and the elderly patients. Also, there were no differences between patients without a diverting stoma and patients in whom bowel continuity had been restored. Elderly females had significantly worse scores on the FIQoL subscales of coping/behavior (P = 0.043) and depression/self-perception (P = 0.004) than young females. Elderly females scored worse on coping/behavior (P = 0.010) and depression/self-perception (P = 0.036) than elderly males. Young and elderly males had comparable scores.

Conclusion

Quality of life with regard to fecal incontinency is worse in elderly females after sphincter-preserving surgery for rectal cancer. Patients should be informed of this impact, and a definite stoma may be considered in this patient group.

Citations

Citations to this article as recorded by

Analyzing quality of life after low anterior resection for rectal cancer
Seyed Mostafa Meshkati Yazd, Reza Shahriarirad, Shayan Almasi, Darioush Naddaffard, Saman Sheikhi, Imana Mosayebi, Kimia Goudarzi, Seyed Mohsen Ahmadi Tafti, Behnam Behboudi, Alireza Kazemeini, Mohammad Reza Keramati
Irish Journal of Medical Science (1971 -).2024;[Epub] CrossRef
Patient-reported Bowel Function and Bowel-related Quality of Life After Pelvic Radiation for Rectal Adenocarcinoma: The Impact of Radiation Fractionation and Surgical Resection
Michael K. Rooney, Brian De, Kelsey Corrigan, Grace L. Smith, Cullen Taniguchi, Bruce D. Minsky, Ethan B. Ludmir, Eugene J. Koay, Prajnan Das, Albert C. Koong, Oliver Peacock, George Chang, Y. Nancy You, Van K. Morris, Graciela Nogueras-González, Emma B.
Clinical Colorectal Cancer.2023; 22(2): 211. CrossRef
Functional outcomes and local control are acceptable following hand‐sewn colo‐anal anastomoses for rectal cancer: Results of long‐term follow‐up
David Hudson, Fiona Entriken, Rupert Hodder, Michael Warner
ANZ Journal of Surgery.2022; 92(3): 390. CrossRef
Functional Bowel Complaints and the Impact on Quality of Life After Colorectal Cancer Surgery in the Elderly
Stijn H. J. Ketelaers, Maarten van Heinsbergen, Ricardo G. Orsini, F. Jeroen Vogelaar, Joop L. M. Konsten, Grard A. P. Nieuwenhuijzen, Harm J. T. Rutten, Jacobus W. A. Burger, Johanne G. Bloemen
Frontiers in Oncology.2022;[Epub] CrossRef
Symptoms affecting quality of life after sphincter-saving rectal cancer surgery: A systematic review
Jennie Burch, Claire Taylor, Ana Wilson, Christine Norton
European Journal of Oncology Nursing.2021; 52: 101934. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef
The Artificial Bowel Sphincter in the Treatment of Fecal Incontinence, Long-term Complications
Aart A. van der Wilt, Stéphanie O. Breukink, Rosel Sturkenboom, Laurents P. Stassen, Cornelius G. Baeten, Jarno Melenhorst
Diseases of the Colon & Rectum.2020; 63(8): 1134. CrossRef
Health-Related Quality of Life in Older Adults with Colorectal Cancer
Evan Lapinsky, Lillian C. Man, Amy R. MacKenzie
Current Oncology Reports.2019;[Epub] CrossRef
Quality of life and anterior resection syndrome after surgery for mid to low rectal cancer: A cross-sectional study
Loris Trenti, Ana Galvez, Sebastiano Biondo, Alejandro Solis, Francesc Vallribera-Valls, Eloy Espin-Basany, Alvaro Garcia-Granero, Esther Kreisler
European Journal of Surgical Oncology.2018; 44(7): 1031. CrossRef
Late assessment of quality of life in patients with rectal carcinoma: comparison between sphincter preservation and definitive colostomy
Mariane Messias Reis Lima Silva, Samuel Aguiar Junior, Juliana de Aguiar Pastore, Érica Maria Monteiro Santos, Fábio de Oliveira Ferreira, Ranyell Matheus S. B. Spencer, Vinicius F. Calsavara, Wilson Toshihiko Nakagawa, Ademar Lopes
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Chirurgische Therapie des Karzinoms des unteren Rektumdrittels
A. D. Rink
coloproctology.2017; 39(6): 411. CrossRef
Quality of Life After a Low Anterior Resection in Elderly Patients
Byung Chun Kim
Annals of Coloproctology.2016; 32(1): 5. CrossRef

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, Verena N. N. Kornmann, Djamila Boerma, Marnix A. J. de Roos, Henderik L. van Westreenen; Ann Coloproctol. 2015;31(1):23-28. Published online February 28, 2015; DOI: https://doi.org/10.3393/ac.2015.31.1.23

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Abstract PDF

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.

Citations

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Health-related Quality of Life of Patients with Rectal Cancer.: Min, Hyo Suk , Kim, Ji Yeon; J Korean Soc Coloproctol. 2009;25(2):100-106.; DOI: https://doi.org/10.3393/jksc.2009.25.2.100

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Abstract PDF

PURPOSE
This study was a latitudinal descriptive effort to understand the degree of quality of life of patients who had undergone a rectal cancer operation. METHODS: The Korean versions of European Orgaization for Research and Treatment of Cancer (EORTC)-Quality of life Questionnaire 30 (QLQ-C30) and Colorectal Cancer-specific Core Questionnaire (QLQ-CR38) were used to examine the degree of quality of life of patients who had undergone a rectal cancer operation. The subjects of this study were 155 patients who had been diagnosed as having rectal cancer and who had received an anterior resection (AR), a low anterior resection (LAR), or an abdominoperineal resection (APR).
RESULTS
In our study, patients' responses were combined and converted to a 0-100 scale according to the guidelines provided by the EORTC Center. From these guidelines, high functional scores (0-100) represent good function and high symptom scores (100-0) signify more problems. The APR patients had their social and family life disrupted (social functioning) and were less able to get about and look after themselves (physical functioning), and they felt themselves to be less attractive (body image). In addition, the scores for stoma problems were worse than those for pain and for male sexual problems. The AR patients and the LAR patients, despite suffering diarrhea, symptoms of insomnia, and defecation problems, had better quality of life than the APR patients without anorectal function. CONCLUSION: If the quality of life of rectal cancer patients is to be maintained and their rate of survival is to be increased, an understanding of the patients' situation, education on self-management related to stoma, and active provision of support from medical teams to solve the discomfort caused by the operation are needed.

Citations

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The Effect of Nutrition Intervention with Oral Nutritional Supplements on Pancreatic and Bile Duct Cancer Patients Undergoing Chemotherapy
Seong Hyeon Kim, Song Mi Lee, Hei Cheul Jeung, Ik Jae Lee, Joon Seong Park, Mina Song, Dong Ki Lee, Seung-Min Lee
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Factors Influencing Quality of Life during Chemotherapy for Colorectal Cancer Patients in South Korea
Yongae Baek, Myungsun Yi
Journal of Korean Academy of Nursing.2015; 45(4): 604. CrossRef
Sexual Function After a Proctectomy for the Treatment of Rectal Cancer
Young Wan Kim, Ik Yong Kim
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Relationships between Anxiety, Depression, Low Anterior Resection Syndrome, and Quality of Life Following Lower Anterior Resection for Rectal Cancer
Eun Lee, Keum Soon Kim
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The Correlation between Quality of Life and Functional Outcome after Restorative Proctocolectomy and Ileal Pouch-Anal Anastomosis.: Yoon, Eyi Sang , Lee, Kil Yeon , Lee, Suk Hwan , Yoon, Choong; J Korean Soc Coloproctol. 2006;22(1):15-23.

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Abstract PDF: PURPOSE
The restorative proctocolectomy (RP) and ileal pouch-anal anastomosis (IPAA) has been accepted as the operation of choice for chronic ulcerative colitis (CUC) and familial adenomatous polyposis (FAP). However, much is still unknown about the functional outcome and the quality of life (QoL) in patients undergoing RP. The aims of this study were to evaluate the functional outcome and the QoL in patients undergoing RP and to assess the correlation between functional outcome and QoL.
METHODS
The medical records of 20 patients who had undergone a RP for CUC (n=11) and FAP (n=9) from January 1993 to December 2003 were reviewed. The QoL was evaluated with the Korean version of Short Form 36 (SF-36) by telephone interview. The functional outcome was assessed by means of the Global Assessment of Function Scale (GAFS). The QoL of patients was compared with that of the general population matched for age and gender (n=107) with including the 7 men, the median age will be thought to be that of the 13 women.
RESULTS
There were 7 men (35%) and 13 women (65%), and the median age was 46 years. The QoL in patients undergoing RP was comparable to that of the healthy general population on all scales. The Physical Component Summary (PCS) was correlated significantly with the daytime and the nighttime incontinence (P<0.01). The Mental Component Summary (MCS) was correlated significantly with the daytime and the nighttime incontinence and the daytime bowel movement (P<0.05).
CONCLUSIONS
This study demonstrates that the QoL in patients undergoing RP is excellent and that the daytime incon tinence and the nighttime incontinence are significant factor influencing the QoL.

A Survey on Ostomates With the special reference to physical, psychosocial and sexual problems.: So, Hyun Seog , Lee, Seok Hwan , Ko, Young Gwan , Oh, Soo Myung , Yoon, Choong , Joo, Hoong Zae , Lee, Kee Hyung; J Korean Soc Coloproctol. 1998;14(3):447-454.

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Abstract PDF: The survey was undertaken among the 105 ostomates who attended the 2nd Workshop for Stoma Rehabilitation on Aug. 30th, 1997 by the Department of Surgery, Kyung-Hee University Hospital to assess the physical, psychosocial and sexual problems with a stoma. The 97% of ostomates had permanent colostomies following abdominoperineal resection. The 67% of ostomates had one or more physical problems caused by stoma. Frequent bowel movement (94.3%), impairment of irrigation (64.6%), unpleasant odor (27.3%), and urinary frequency (21.3%) were common problems encountered by ostomates. Concerning the psychosocial problems, 3.8% of them suffered from profound restriction of social activities and 1.9% of them had psychologic problems such as depression. 42 of 58 ostomates (72.4%) who were employed before operation returned to their work. Among 71 men, 44 (62%) were impaired by sexual function. Most ostomates suffered physical, social, psychologic and sexual problems in their daily life and needed helps of experts such colorectal surgeons, enterostomal therapists, and ostomy association. Attention is needed more to improve the quality of life for the ostomates.

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