Treatment options to improve anorectal function following rectal resection: a systematic review

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Pelvic Floor Rehabilitation

Background:

• Rectal resection can lead to significant anorectal dysfunction, including fecal incontinence and evacuation difficulties.
• Various therapeutic options exist to manage these post-surgical complications.
• Improving anorectal function is crucial for patient quality of life after rectal surgery.

Purpose of the Study:

• To systematically review treatment outcomes for improving anorectal function post-rectal surgery.
• To assess the efficacy of different therapeutic approaches on fecal incontinence and defecation quality.
• To evaluate the impact of treatments on patients' quality of life.

Main Methods:

• A systematic literature search was conducted across multiple databases (MEDLINE, PubMed, EMBASE, etc.).
• Included studies focused on therapeutic interventions to enhance anorectal function after rectal surgery.
• Outcome parameters included symptomatic improvement of fecal incontinence, defecation evaluation, and quality of life.

Main Results:

• Fifteen studies were included, evaluating pelvic floor re-education (7 studies), colonic irrigation (2 studies), and sacral nerve stimulation (SNS) (6 studies).
• Pelvic floor re-education and SNS showed improvements in incontinence scores, reduced incontinent episodes, and enhanced resting/squeeze pressures.
• Quality of life improved in studies utilizing pelvic floor re-education and SNS.

Conclusions:

• Conservative therapies like pelvic floor re-education and colonic irrigation demonstrate potential in improving anorectal function.
• Sacral nerve stimulation (SNS) may offer benefits for specific patient groups.
• Further high-quality studies, particularly randomized controlled trials, are necessary to establish evidence-based conclusions.