title: Persisting anorectal dysfunction after rectal cancer surgery.
abstract: OBJECTIVE
  Sphincter-saving rectal cancer management affects anorectal function. This study evaluated persisting anorectal dysfunction and its impact on patients' well-being.
  
  
  METHODS
  Seventy-nine patients with a follow-up of 12-37 (median 22) months and 79 age- and sex-matched control subjects completed questionnaires.
  
  
  RESULTS
  The median number of diurnal bowel movements was three in patients and one in controls (P < 0.0001). Nocturnal defaecation occurred in 53% of patients. The median Vaizey score was 8 in patients and 4 in controls (P < 0.0001). Urgency without incontinence was reported by 47% of patients and 49% of controls (P = 0.873), soiling by 28% of patients and 3% of controls (P < 0.0001), incontinence for flatus by 73% of patients and 49% of controls (P = 0.0019), and incontinence for solid stools by 16% of patients and 4% of controls (P = 0.0153). Incontinence of liquid stools occurred in 17 of 20 patients and in one of five controls who had liquid stools (P = 0.0123). Incontinence for gas, liquid or solid stool occurred once or more weekly in 47%, 19% and 6% of patients respectively. Evacuation difficulties were reported by 98% of patients, but also by 77% of controls. Neoadjuvant radio(chemo)therapy adversely affected defaecation frequency and continence. Incontinence was associated with severe discomfort in 50% of patients, severe anxiety in 40% and severe embarrassment in 48%.
  
  
  CONCLUSIONS
  Anorectal dysfunction is a frequent problem after management of rectal cancer with an impact on the well-being of patients.
authors.affiliation: Department of Rehabilitation Sciences, Neuromotor Rehabilitation Research Group, KU Leuven, Leuven, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Maris
authors.forename: F
authors.initials: F
authors.lastname: Penninckx
authors.forename: A M
authors.initials: AM
authors.lastname: Devreese
authors.forename: F
authors.initials: F
authors.lastname: Staes
authors.forename: P
authors.initials: P
authors.lastname: Moons
authors.forename: E
authors.initials: E
authors.lastname: Van Cutsem
authors.forename: K
authors.initials: K
authors.lastname: Haustermans
authors.forename: A
authors.initials: A
authors.lastname: D'Hoore
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000503:physiopathology* / Q000601:surgery*; D000714:Anastomosis, Surgical; D016022:Case-Control Studies; D003106:Colon / Q000601:surgery*; D039021:Colonic Pouches; D003672:Defecation; D005242:Fecal Incontinence / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D059351:Organ Sparing Treatments; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D011795:Surveys and Questionnaires
keywords: Rectal cancer; adverse effects in colorectal surgery; anorectal function; constipation; faecal incontinence; personal satisfaction