title: Functional results after radiochemotherapy and total mesorectal excision for rectal cancer.
abstract: OBJECTIVE
  The aim of this study was to prospectively define and measure evacuation and continence disorders after preoperative radiochemotherapy and total mesorectal excision (TME) for rectal cancer 1 year after surgery.
  
  
  METHODS
  We submitted 100 patients, who underwent neoadjuvant treatment and anterior resection with TME from 1996 to 2003, to a questionnaire on postoperative continence and evacuation. Anal sphincter function was further assessed by the Memorial Sloan-Kettering score. Factors influencing anorectal function were examined in univariate and multivariate analysis.
  
  
  RESULTS
  Median evacuation score was 16.12 +/- 5.12 (range 0-28). Sensation of incomplete evacuation was reported in 58% of cases, necessity to return to the bathroom <15 min in 37% and inability to evacuate completely <15 min in 35%. Median continence score was 13.7 +/- 4.79 (range 0-20). Incontinence to flatus was reported in 46% of cases. Colonic J-pouch allows better evacuation and continence. Continence was also better in absence of postoperative complications. Sphincter function resulted excellent or good in 75% of patients according to the Memorial Sloan-Kettering score.
  
  
  CONCLUSIONS
  The most frequent symptoms in our series are the sensation of incomplete evacuation, the incontinence to flatus, and the necessity to return to the bathroom <15 min. Colonic J-pouch warrants a better function. Postoperative complications compromise good functional results.
authors.affiliation: Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Coco
authors.forename: V
authors.initials: V
authors.lastname: Valentini
authors.forename: A
authors.initials: A
authors.lastname: Manno
authors.forename: G
authors.initials: G
authors.lastname: Rizzo
authors.forename: M A
authors.initials: MA
authors.lastname: Gambacorta
authors.forename: C
authors.initials: C
authors.lastname: Mattana
authors.forename: A
authors.initials: A
authors.lastname: Verbo
authors.forename: A
authors.initials: A
authors.lastname: Picciocchi
mesh_terms: D000368:Aged; D001003:Anal Canal / Q000503:physiopathology*; D000714:Anastomosis, Surgical / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D039021:Colonic Pouches / Q000009:adverse effects*; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005242:Fecal Incontinence / Q000209:etiology* / Q000503:physiopathology; D005414:Flatulence / Q000209:etiology* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D017060:Patient Satisfaction; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D020127:Recovery of Function; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome