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[Can continence function after rectal resection be prognostically estimated?].

U Stadelmaier1, B Bittorf, M Meyer

  • 1Chirurgische Klinik mit Poliklinik, Universität Erlangen-Nürnberg. Uwe.Stadelmaier@chir.imed.uni-erlangen.de

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|October 3, 2000
PubMed
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Predicting continence after rectal cancer surgery is possible. Key factors include anastomosis level, resting pressure, rectal compliance, and prior radiochemotherapy, enabling a predictive score before ileostomy closure.

Area of Science:

  • Colorectal surgery
  • Gastroenterology
  • Oncology

Context:

  • Rectal resection for cancer often necessitates a temporary ileostomy.
  • Restoring bowel continuity involves ileostomy closure.
  • Predicting post-closure continence is crucial for patient quality of life.

Purpose:

  • To identify clinical and physiological predictors of fecal continence after ileostomy closure.
  • To develop a formula for calculating a continence score pre-closure.

Summary:

  • A study evaluated 65 patients (24 with prior radiochemotherapy) undergoing rectal resection and ileostomy closure.
  • Clinical examination, anorectal manometry, and contrast enema were used to assess parameters before closure.
  • Continence was evaluated post-closure using the Wexner score; significant correlations were found with anastomosis level, resting pressure, rectal compliance, and radiochemotherapy.

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Impact:

  • Identifies key factors influencing continence post-rectal resection and ileostomy closure.
  • Provides a practical formula for predicting continence scores, aiding surgical decision-making.
  • Highlights the negative impact of radiochemotherapy on post-operative continence.