title: Functional Outcomes of Patients Treated with Intensive Medications for Bowel and Pain Control for Low-Lying Rectal Cancer Who Received Preoperative Chemoradiotherapy.
abstract: OBJECTIVE
  The aim of this study was to assess the functional outcomes of patients treated with intensive medications for bowel and pain control for low-lying rectal cancer who received preoperative chemoradiotherapy (CRT).
  
  
  METHODS
  The inclusion criterion was sphincter-preserving surgery following CRT for T3 middle and low rectal cancer. Postoperative defecation control was conducted using calcium polycarbophil and loperamide, and anal pain control was conducted using oxycodone hydrochloride hydrate. The functional outcomes were determined by an annual questionnaire after stoma closure.
  
  
  RESULTS
  Of 64 patients evaluated, 33 were reconstructed using the double stapling technique (DST) and 31 were reconstructed using the intersphincteric resection (ISR) technique. The median Visual Analogue Scale at ISR was improved from 7 to 1.5 at 1 year after surgery. The median Wexner scores were 6.0, 6.0, 5.0 and 5.0 for DST and 14.5, 12.0, 10.0 and 8.0 for ISR for the first 4 years, respectively. The only independent predictor of a poor bowel function (Wexner score >10) according to a multivariate analyses was pelvic infection (OR 3.994, 95% CI 1.235-13.52, p = 0.021), while ISR was not a predictor.
  
  
  CONCLUSIONS
  Anal pain following ISR can be controlled with oxycodone hydrochloride hydrate therapy. ISR is feasible following CRT for low-lying rectal cancer.
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Beppu
authors.forename: Kimura
authors.initials: K
authors.lastname: Fumihiko
authors.forename: Doi
authors.initials: D
authors.lastname: Hiroshi
authors.forename: Kamikonya
authors.initials: K
authors.lastname: Norihiko
authors.forename: Nagahide
authors.initials: N
authors.lastname: Matsubara
authors.forename: Naohiro
authors.initials: N
authors.lastname: Tomita
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yanagi
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamanaka
mesh_terms: D000180:Acrylic Resins / Q000627:therapeutic use; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000714:Anastomosis, Surgical; D000930:Antidiarrheals / Q000627:therapeutic use; D059186:Chemoradiotherapy, Adjuvant; D003672:Defecation; D003967:Diarrhea / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008139:Loperamide / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010098:Oxycodone / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011300:Preoperative Care; D012004:Rectal Neoplasms / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D012007:Rectum / Q000601:surgery*; D017792:Surgical Stapling / Q000379:methods
chemical_list: D000180:Acrylic Resins; D000701:Analgesics, Opioid; D000930:Antidiarrheals; D008139:Loperamide; C030312:calcium polycarbophil; D010098:Oxycodone