Functional outcomes and quality of life after intersphincteric resection with transverse coloplasty pouch anastomosis for ultralow rectal cancer: a prospective cohort study.

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Techniques in Coloproctology Pub Date : 2025-06-09 DOI:10.1007/s10151-025-03174-8

Y Jia, B Zhang, Y Zhao, G Zhuo, X Song, J Xiang, J Ding

{"title":"Functional outcomes and quality of life after intersphincteric resection with transverse coloplasty pouch anastomosis for ultralow rectal cancer: a prospective cohort study.","authors":"Y Jia, B Zhang, Y Zhao, G Zhuo, X Song, J Xiang, J Ding","doi":"10.1007/s10151-025-03174-8","DOIUrl":null,"url":null,"abstract":"Background: Functional outcomes and quality of life (QoL) of transverse coloplasty pouch (TCP) in intersphincteric resection (ISR) for ultralow rectal cancer remain poorly understood.Methods: A prospective analysis was conducted on patients who received ISR treatment from January 2020 to May 2022. Patients were divided into TCP and straight coloanal anastomosis (SCAA) groups. Comparisons were made for low anterior resection syndrome (LARS) score, Wexner incontinence score (WIS), Kirwan's incontinence score, visual analog scale (VAS), and fecal incontinence quality of life (FIQL) questionnaire at 3, 6, and 12 months post ileostomy closure. Additionally, anorectal manometry outcomes were compared pre ileostomy closure.Results: A total of 75 patients were included, with 25 in the TCP group and 50 in the SCAA group. At 3, 6, 12 months post ileostomy closure, the TCP group showed significantly lower LARS (31, 30, 28; p = 0.033, 0.044, 0.019, respectively), WIS (11.04, 9.92, 7.32; p = 0.025, 0.043, 0.007, respectively), and Kirwan's incontinence scores (p = 0.044, 0.033, 0.022). Additionally, the TCP group showed higher VAS (5, 6, 7; p = 0.004, 0.006, 0.005, respectively) and FIQL summary scores (2.67, 2.79, 2.86; p = 0.001, 0.002, 0.004, respectively). Prior to ileostomy closure, the rectal first sensation and maximum tolerance volumes were significantly higher in the TCP group compared to the SCAA group (22 ml vs. 20 ml, 51.56 ml vs. 34.52 ml; p = 0.019, 0.038, respectively). There were no significant differences in postoperative complications or recurrence rates between the groups.Conclusions: TCP is a safe technique, which may improve bowel function and QoL in ISR patients with low rectal cancer within 1 year.","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"130"},"PeriodicalIF":2.9000,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148994/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Coloproctology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10151-025-03174-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Functional outcomes and quality of life (QoL) of transverse coloplasty pouch (TCP) in intersphincteric resection (ISR) for ultralow rectal cancer remain poorly understood.

Methods: A prospective analysis was conducted on patients who received ISR treatment from January 2020 to May 2022. Patients were divided into TCP and straight coloanal anastomosis (SCAA) groups. Comparisons were made for low anterior resection syndrome (LARS) score, Wexner incontinence score (WIS), Kirwan's incontinence score, visual analog scale (VAS), and fecal incontinence quality of life (FIQL) questionnaire at 3, 6, and 12 months post ileostomy closure. Additionally, anorectal manometry outcomes were compared pre ileostomy closure.

Results: A total of 75 patients were included, with 25 in the TCP group and 50 in the SCAA group. At 3, 6, 12 months post ileostomy closure, the TCP group showed significantly lower LARS (31, 30, 28; p = 0.033, 0.044, 0.019, respectively), WIS (11.04, 9.92, 7.32; p = 0.025, 0.043, 0.007, respectively), and Kirwan's incontinence scores (p = 0.044, 0.033, 0.022). Additionally, the TCP group showed higher VAS (5, 6, 7; p = 0.004, 0.006, 0.005, respectively) and FIQL summary scores (2.67, 2.79, 2.86; p = 0.001, 0.002, 0.004, respectively). Prior to ileostomy closure, the rectal first sensation and maximum tolerance volumes were significantly higher in the TCP group compared to the SCAA group (22 ml vs. 20 ml, 51.56 ml vs. 34.52 ml; p = 0.019, 0.038, respectively). There were no significant differences in postoperative complications or recurrence rates between the groups.

Conclusions: TCP is a safe technique, which may improve bowel function and QoL in ISR patients with low rectal cancer within 1 year.

查看原文本刊更多论文

一项前瞻性队列研究：超低位直肠癌括约肌间切除联合横结成形术袋吻合术的功能结局和生活质量。

背景：在超低位直肠癌的括约肌间切除术（ISR）中，横结肠成形术袋（TCP）的功能结局和生活质量（QoL）尚不清楚。方法：对2020年1月至2022年5月接受ISR治疗的患者进行前瞻性分析。患者分为TCP组和直结肠肛管吻合组（SCAA）。比较回肠造口术后3、6、12个月的低前切除术综合征（LARS）评分、Wexner失禁评分、Kirwan失禁评分、视觉模拟量表（VAS）和大便失禁生活质量（FIQL）问卷。此外，肛门直肠测压结果与回肠造口术前比较。结果：共纳入75例患者，其中TCP组25例，SCAA组50例。在回肠造口关闭后3、6、12个月，TCP组的LARS显著降低(31,30,28；p = 0.033, 0.044, 0.019), WIS (11.04, 9.92, 7.32；p = 0.025, 0.043, 0.007)， Kirwan失禁评分（p = 0.044, 0.033, 0.022）。此外，TCP组VAS更高(5,6,7；p = 0.004, 0.006, 0.005)和FIQL综合评分(2.67,2.79,2.86；P分别= 0.001,0.002,0.004)。在回肠造口关闭前，TCP组的直肠第一感觉和最大耐受量明显高于SCAA组(22 ml vs 20 ml, 51.56 ml vs 34.52 ml；P = 0.019, 0.038)。两组术后并发症及复发率无明显差异。结论：TCP是一种安全的技术，可改善ISR合并低位直肠癌患者1年内的肠功能和生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.