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Bowel function survey after segmental colorectal resections

Y H Ho1, D Low, H S Goh

  • 1Department of Colorectal Surgery, Singapore General Hospital, Singapore.

Diseases of the Colon and Rectum
|March 1, 1996
PubMed
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Bowel function issues are more common after sigmoid colectomy (SC) and anterior resection (AR) compared to more proximal surgeries like right hemicolectomy (RHC). Patients undergoing SC and AR reported more frequent defecation problems and continence issues impacting lifestyle.

Area of Science:

  • Colorectal surgery outcomes
  • Gastrointestinal function research
  • Patient-reported outcome measures

Background:

  • Understanding long-term bowel function is crucial for patients undergoing colorectal resections.
  • Different surgical approaches for colon cancer may impact postoperative gastrointestinal function differently.
  • Previous studies have focused on short-term outcomes, necessitating research into long-term functional recovery.

Purpose of the Study:

  • To evaluate and compare long-term bowel function after various colorectal resection procedures.
  • To assess stool frequency, fecal continence, and defecation problems in patients post-surgery.
  • To identify specific surgical sites associated with higher rates of bowel dysfunction.

Main Methods:

  • A questionnaire-based study involving 315 patients who underwent surgery at least one year prior.

Related Experiment Videos

  • Data collected on stool frequency, fecal continence, and defecation problems.
  • Exclusion of patients with anastomotic leaks or tumor recurrence to ensure focus on surgical impact.

    • Main Results:

    • Patients undergoing anterior resection (AR) and sigmoid colectomy (SC) reported significantly lower stool frequency (44.8% and 64.3% respectively) compared to more proximal resections (P=0.01).
    • Continence issues impacted lifestyle in 32% of AR patients, versus up to 11.5% after proximal resections (P=0.001).
    • Defecation problems were more frequent after SC (25%) and AR (28.4%) than after right hemicolectomy (RHC), extended right hemicolectomy (ERHC), and left hemicolectomy (LHC) (P=0.009).

    Conclusions:

    • Sigmoid colectomy (SC) and anterior resection (AR) are associated with a higher incidence of long-term bowel function problems.
    • Postoperative bowel dysfunction, including continence and defecation issues, is significantly more prevalent after distal colorectal resections.
    • These findings highlight the importance of patient counseling and potential management strategies for bowel dysfunction after SC and AR.