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The evaluation of postoperative bowel dysfunction in Japanese patients with rectal cancer

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Abstract

Purpose

The present study assessed postoperative bowel dysfunction in Japanese patients with rectal cancer, including patients who underwent preoperative radiotherapy (RT).

Methods

A total of 277 rectal cancer patients who underwent primary resection were included in the analyses. A questionnaire survey was administered using the low anterior resection syndrome (LARS) score and Wexner score. Scores were determined one year after rectal surgery or diverting ileostomy closure. The LARS score was categorized as minor LARS (21–29) and major LARS (30–42).

Results

The proportions of patients with minor and major LARS were significantly larger and Wexner scores significantly higher in patients with distal tumors and a lower anastomosis level than in those with proximal tumors and a higher anastomosis level. Among the patients with lower rectal cancer, the proportions with minor and major LARS were similar between those with and without preoperative RT. The Wexner scores in patients with preoperative RT were significantly higher than in patients without RT. A distal tumor location and lower anastomosis level were independent risk factors of major LARS in multivariate analyses.

Conclusion

A distal tumor location, low anastomosis level, and preoperative RT might be associated with postoperative bowel dysfunction in rectal cancer patients.

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Acknowledgements

We thank Jane Charbonneau, DVM, from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Surgery, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965, Japan

    Yuki Kiyozumi

  2. Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Toshiya Nagasaki, Toshiki Mukai, Yukiharu Hiyoshi, Tomohiro Yamaguchi, Takashi Akiyoshi & Yosuke Fukunaga

  3. Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Shimpei Matsui

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  1. Yuki Kiyozumi
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Correspondence to Toshiya Nagasaki.

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Kiyozumi, Y., Nagasaki, T., Matsui, S. et al. The evaluation of postoperative bowel dysfunction in Japanese patients with rectal cancer. Surg Today 53, 596–604 (2023). https://doi.org/10.1007/s00595-022-02598-1

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