Original researchImprovement of Fecal Incontinence and Quality of Life by Electrical Stimulation and Biofeedback for Patients With Low Rectal Cancer After Intersphincteric Resection
Section snippets
Methods
Radical proctectomy with the ISR technique was performed in patients with low rectal cancer, which showed no external sphincter or levator ani muscle invasion. Patients who experienced frequent defecation, urgency, incomplete evacuation, stool fragmentation, or uncontrolled loss of stool after sphincter-saving surgery with the ISR technique were selected to undergo the present rehabilitation training program. Patients were excluded if they had the following conditions: anorectal injury after
Results
Between November 2009 and December 2013, 85 patients with very low rectal malignancy received a sphincter-saving operation by the ISR technique with hand-sewn coloanal anastomosis. There were 31 patients who received a laparoscopic procedure, and 54 patients had robot-assisted surgery. Thirty-two patients were included in the present study. The demographic characteristics of the patients are listed in table 1. There were 15 women (46.9%) and 17 men (53.1%), with a mean age of 56.5 years (range,
Discussion
More than 75% of patients receiving radical proctectomy and sphincter-saving surgery experience anorectal symptoms and defecatory disorders to some extent.10, 11, 12, 13, 14 These dysfunctions may result from irradiation effects on the anal sphincter, dysfunctional pelvic floor, and anal sphincter muscle after operation, autonomic nerve insult during operation, anatomic changes of the reservoir, adjuvant treatment, food intake, physical condition, or time interval after surgery.6, 13, 14, 15, 16
Conclusions
Our data show that NMES plus BF effectively improves both functional results and QOL for patients undergoing sphincter-saving rectal cancer resection. Large prospective randomized trials are needed to assess the long-term functional outcomes and clarify and standardize the result of pelvic rehabilitation programs.
Suppliers
- a.
Myomed 932; Enraf Nonius International.
- b.
SAS version 9.3; SAS Institute.
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2021, Journal of Pain and Symptom ManagementCitation Excerpt :Three additional studies were described as a tertiary referral unit,22 a physiotherapy clinic36 and one in a medical centre,35 which may also indicate the study was conducted within a hospital setting. Only five studies reported who conducted the intervention; three were by a nurse20,30,38 and two by a physiotherapist.36,40 Sixteen studies reported more male than female patients.15,16,19,22,24,26,29,30,33,35-37,39,41-43
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Disclosures: none.
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L.-J. Kuo and Y.-C. Lin contributed equally to this work.