Our Summary

This research paper aimed to understand the changes in bowel function, specifically Low Anterior Resection Syndrome (LARS), over 18 months following a surgery called restorative proctectomy for rectal cancer. This surgery is known to result in a high incidence of LARS, a condition relating to bowel dysfunction after the operation.

The study analyzed data from rectal cancer patients who had undergone restorative proctectomy and had their bowel function measured at least three times in the first 18 months post-surgery. By using a method called Latent-class growth curve analysis, the researchers were able to identify different patterns of how LARS changed over time and categorize patients into these patterns.

From 95 patients included in the study, the researchers found three distinct groups. The first group, making up 26% of the patients, had minimal LARS symptoms that remained stable over time. The second group, which consisted of 28% of the patients, initially had minor LARS symptoms that improved with time. The third group, comprising 45% of the patients, had consistently high LARS symptoms throughout the 18 months. The patients in the third group were more likely to have undergone certain treatments like neoadjuvant therapy, intersphincteric resection, and proximal diversion.

In simple terms, the researchers found three main patterns of how bowel function changes after a specific surgery for rectal cancer. This information could be used to give patients a more accurate expectation of their bowel function after surgery.

FAQs

  1. What is Low Anterior Resection Syndrome (LARS)?
  2. What were the main findings of the study on changes in bowel function following restorative proctectomy for rectal cancer?
  3. Can the patterns of bowel function changes after restorative proctectomy predict the likelihood of certain treatments being used?

Doctor’s Tip

A helpful tip a doctor might tell a patient about proctectomy is to maintain a healthy diet high in fiber and to stay hydrated to help regulate bowel movements and prevent constipation. Additionally, regular physical activity can also help improve bowel function and overall recovery after surgery. It’s important to communicate any changes in bowel habits to your healthcare provider so they can provide appropriate management and support.

Suitable For

Patients who are typically recommended for proctectomy are those who have rectal cancer that cannot be treated with other methods such as radiation therapy or chemotherapy. These patients may have advanced stage rectal cancer or recurrent cancer that requires surgical removal of the rectum. Additionally, patients who have inflammatory bowel disease such as ulcerative colitis or Crohn’s disease may also be recommended for proctectomy if their condition is not responsive to other treatments.

Timeline

Before the proctectomy surgery, the patient would have likely undergone various tests and consultations to determine the best course of treatment for their rectal cancer. This may have included chemotherapy and/or radiation therapy to shrink the tumor before surgery. The patient would have also received pre-operative instructions on diet, bowel preparation, and general pre-surgical care.

After the proctectomy surgery, the patient would have experienced a recovery period in the hospital, which typically lasts for a few days to a week depending on the extent of the surgery and individual factors. The patient would have received post-operative care such as pain management, wound care, and instructions on resuming normal activities.

In the following weeks and months, the patient would have likely experienced changes in bowel function as they adjusted to the new anatomy resulting from the surgery. This may include bowel frequency, urgency, incontinence, and other symptoms related to LARS. The patient would have attended follow-up appointments with their healthcare provider to monitor their progress and address any concerns.

Over time, the patient’s bowel function may improve or stabilize, as seen in the different patterns identified in the study. However, some patients may continue to experience persistent LARS symptoms that may require ongoing management and support. By understanding these potential outcomes, healthcare providers can better educate and support patients throughout their recovery journey.

What to Ask Your Doctor

Some questions a patient should ask their doctor about proctectomy include:

  1. What are the potential side effects and complications of restorative proctectomy?
  2. How likely am I to experience Low Anterior Resection Syndrome (LARS) following this surgery?
  3. What can I do to manage or alleviate symptoms of LARS if I experience it?
  4. Are there any specific factors or treatments that may increase my risk of developing LARS?
  5. How often will I need follow-up appointments to monitor my bowel function after the surgery?
  6. Are there any dietary or lifestyle changes I should make to improve my bowel function post-surgery?
  7. What are the long-term effects on bowel function that I can expect after undergoing restorative proctectomy?
  8. Are there any support groups or resources available for patients experiencing bowel dysfunction after this type of surgery?
  9. How can I communicate effectively with my healthcare team about any changes in my bowel function post-surgery?
  10. Are there any alternative treatments or interventions that may help improve my bowel function if I experience persistent LARS symptoms?

Reference

Authors: Al-Rashid F, Robitaille S, Liberman AS, Charlebois P, Stein B, Feldman LS, Fiore JF Jr, Lee L. Journal: Tech Coloproctol. 2022 Mar;26(3):195-203. doi: 10.1007/s10151-021-02561-1. Epub 2022 Jan 18. PMID: 35039911