Evaluating long-term bowel function after low-anterior surgery for rectal cancer

This study investigated the long-term side effects of low anterior surgery for rectal cancer. Researchers suggested that radiation before surgery is associated with poorer bowel function after surgery.

Rectal cancer is a frequent and serious disease. In the US there are 43,340 new cases of rectal cancer every year. The standard treatment was rectal surgery. However, this is associated with high rates of bowel dysfunction which decreases the quality of life of these patients.

There are a limited number of studies on side effects long-term after rectal surgery on bowel function and quality of life. These studies showed that side effects were found in 47.5 to 90% of rectal cancer patients after surgery. However, the long-term side effects on bowel and quality of life and factors that influence these are still not clear.

The study included information about 125 patients with rectal cancer who underwent surgery at least 5 years before. Patients filled in questionnaires related to bowel function and quality of life. Possible risk factors for long-term bowel disorder after surgery were also assessed. The average follow-up was 7.5 years.

Overall, 58 (46.4%) patients had long-term effects on bowel function. Of these, 33 (26.4%) had major side effects and 25 (20%) had a minor effect. 67 (56.6%) reported no bowel side effects. 82 patients reported fecal incontinence (leakage of feces). Of these, 55 (44%) had minor incontinence, 18 (14.4%) had medium incontinence, and 9 (7.2%) had major incontinence.

28% of the patients received radiotherapy before surgery. 10.4% of patients received both radiotherapy and chemotherapy before surgery. Radiotherapy and/or chemotherapy before surgery was the only significant risk factor for long-term bowel side effects.

This study concluded that bowel side effects are long-lasting side effects in patients treated with low anterior surgery andy radiation therapy with or without chemotherapy before surgery was associated with an increased risk of late bowel side effects in these patients.

This study included a limited number of participants. Further studies with bigger populations are needed.