Post anterior rectal resection syndrome--a retrospective multicentre study

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Anterior resection of the rectum is a common procedure for rectal cancer.
• Postoperative bowel dysfunction, including increased stool frequency and incontinence (Anterior Resection of the Rectum Syndrome - ARRS), is a significant concern.
• Factors influencing ARRS and long-term outcomes require further investigation.

Purpose of the Study:

• To investigate the effects of surgical characteristics on ARRS symptoms at 1 month and over 1 year postoperatively following anterior resection of the rectum.
• To assess the prevalence and resolution of ARRS using a simplified definition.

Main Methods:

• Retrospective study of 106 patients who underwent anterior resection for rectal cancer between 2002-2006.
• Patients were interviewed at 1 month and over 1 year postoperatively regarding ARRS symptoms.
• ARRS was defined as incontinence and/or frequent bowel movements, graded as severe, moderate, or mild.

Main Results:

• ARRS was prevalent in 55.6% of patients at 1 month postoperatively, with over half experiencing improvement by 1 year.
• The level of anastomosis was associated with early ARRS but not late ARRS, suggesting adaptation.
• Total mesorectal excision, adjuvant therapies, patient age, and disease stage did not affect ARRS or continence.

Conclusions:

• The level of anastomosis significantly impacts early ARRS after anterior resection but not long-term outcomes.
• Further research is needed on neorectal reservoir reconstruction and the simpler ARRS definition.