Risk factors for persistent anal incontinence after restorative proctectomy in rectal cancer patients with anal incontinence: Prospective cohort study

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Abstract

Background: This study evaluated the notion that preoperative anal incontinence might be a potent predictive factor for anal incontinence (AI) after restorative proctectomy in rectal cancer patients. The principal objective of this study was to determine the risk factors for persistent anal incontinence following restorative proctectomy. Methods: This study was designed as a single-center, prospective cohort study of a single group of 93 patients who had AI before restorative proctectomy for rectal cancer. The study group was re-evaluated for the presence of AI 12 months after restorative proctectomy or ileostomy takedown. Incontinence severity was determined using the Fecal Incontinence Severity Index (FISI). Logistic regression analysis was performed to identify the clinicopathologic factors associated with persistent AI. Results: Fifteen patients were excluded from analysis due to death within the 12 months after surgery (n = 7), no ileostomy repair (n = 5), loss to follow-up (n = 2), or previous treatment for anal incontinence (n = 1). At 12 months, 53 of 78 patients (67.9%) had persistent AI and 25 patients (32.1 %) had recovered. Multivariate analysis demonstrated that preoperative FISI scores higher than 30 (OR = 11.61, 95% CI 1.43-94.01, p = 0.022) and lower tumor location 5 cm or less from the anal verge (OR = 84.46, 95% CI 3.91-1822.85, p = 0.005) were independent factors for persistent AI. Conclusions: Anal incontinence may persist after restorative proctectomy in rectal cancer patients with high preoperative incontinence scores and lower tumor location. Therefore, this information should be provided when restorative proctectomy is offered for rectal cancer patients.

Original languageEnglish
Pages (from-to)1918-1924
Number of pages7
JournalWorld Journal of Surgery
Volume35
Issue number8
DOIs
StatePublished - 1 Aug 2011

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Rectal Neoplasms
Cohort Studies
Prospective Studies
Ileostomy
Fecal Incontinence
Neoplasms
Multivariate Analysis
Logistic Models
Regression Analysis

Cite this

@article{bd7af59f5e754305bd1e2d538dc63c16,
title = "Risk factors for persistent anal incontinence after restorative proctectomy in rectal cancer patients with anal incontinence: Prospective cohort study",
abstract = "Background: This study evaluated the notion that preoperative anal incontinence might be a potent predictive factor for anal incontinence (AI) after restorative proctectomy in rectal cancer patients. The principal objective of this study was to determine the risk factors for persistent anal incontinence following restorative proctectomy. Methods: This study was designed as a single-center, prospective cohort study of a single group of 93 patients who had AI before restorative proctectomy for rectal cancer. The study group was re-evaluated for the presence of AI 12 months after restorative proctectomy or ileostomy takedown. Incontinence severity was determined using the Fecal Incontinence Severity Index (FISI). Logistic regression analysis was performed to identify the clinicopathologic factors associated with persistent AI. Results: Fifteen patients were excluded from analysis due to death within the 12 months after surgery (n = 7), no ileostomy repair (n = 5), loss to follow-up (n = 2), or previous treatment for anal incontinence (n = 1). At 12 months, 53 of 78 patients (67.9{\%}) had persistent AI and 25 patients (32.1 {\%}) had recovered. Multivariate analysis demonstrated that preoperative FISI scores higher than 30 (OR = 11.61, 95{\%} CI 1.43-94.01, p = 0.022) and lower tumor location 5 cm or less from the anal verge (OR = 84.46, 95{\%} CI 3.91-1822.85, p = 0.005) were independent factors for persistent AI. Conclusions: Anal incontinence may persist after restorative proctectomy in rectal cancer patients with high preoperative incontinence scores and lower tumor location. Therefore, this information should be provided when restorative proctectomy is offered for rectal cancer patients.",
author = "Lee, {Taek Gu} and Kang, {Sung Bum} and Heo, {Suung Chul} and Seung-Yong Jeong and Park, {Kyu Joo}",
year = "2011",
month = "8",
day = "1",
doi = "10.1007/s00268-011-1116-5",
language = "English",
volume = "35",
pages = "1918--1924",
journal = "World journal of surgery",
issn = "0364-2313",
publisher = "Springer New York",
number = "8",

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TY - JOUR

T1 - Risk factors for persistent anal incontinence after restorative proctectomy in rectal cancer patients with anal incontinence

T2 - Prospective cohort study

AU - Lee, Taek Gu

AU - Kang, Sung Bum

AU - Heo, Suung Chul

AU - Jeong, Seung-Yong

AU - Park, Kyu Joo

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Background: This study evaluated the notion that preoperative anal incontinence might be a potent predictive factor for anal incontinence (AI) after restorative proctectomy in rectal cancer patients. The principal objective of this study was to determine the risk factors for persistent anal incontinence following restorative proctectomy. Methods: This study was designed as a single-center, prospective cohort study of a single group of 93 patients who had AI before restorative proctectomy for rectal cancer. The study group was re-evaluated for the presence of AI 12 months after restorative proctectomy or ileostomy takedown. Incontinence severity was determined using the Fecal Incontinence Severity Index (FISI). Logistic regression analysis was performed to identify the clinicopathologic factors associated with persistent AI. Results: Fifteen patients were excluded from analysis due to death within the 12 months after surgery (n = 7), no ileostomy repair (n = 5), loss to follow-up (n = 2), or previous treatment for anal incontinence (n = 1). At 12 months, 53 of 78 patients (67.9%) had persistent AI and 25 patients (32.1 %) had recovered. Multivariate analysis demonstrated that preoperative FISI scores higher than 30 (OR = 11.61, 95% CI 1.43-94.01, p = 0.022) and lower tumor location 5 cm or less from the anal verge (OR = 84.46, 95% CI 3.91-1822.85, p = 0.005) were independent factors for persistent AI. Conclusions: Anal incontinence may persist after restorative proctectomy in rectal cancer patients with high preoperative incontinence scores and lower tumor location. Therefore, this information should be provided when restorative proctectomy is offered for rectal cancer patients.

AB - Background: This study evaluated the notion that preoperative anal incontinence might be a potent predictive factor for anal incontinence (AI) after restorative proctectomy in rectal cancer patients. The principal objective of this study was to determine the risk factors for persistent anal incontinence following restorative proctectomy. Methods: This study was designed as a single-center, prospective cohort study of a single group of 93 patients who had AI before restorative proctectomy for rectal cancer. The study group was re-evaluated for the presence of AI 12 months after restorative proctectomy or ileostomy takedown. Incontinence severity was determined using the Fecal Incontinence Severity Index (FISI). Logistic regression analysis was performed to identify the clinicopathologic factors associated with persistent AI. Results: Fifteen patients were excluded from analysis due to death within the 12 months after surgery (n = 7), no ileostomy repair (n = 5), loss to follow-up (n = 2), or previous treatment for anal incontinence (n = 1). At 12 months, 53 of 78 patients (67.9%) had persistent AI and 25 patients (32.1 %) had recovered. Multivariate analysis demonstrated that preoperative FISI scores higher than 30 (OR = 11.61, 95% CI 1.43-94.01, p = 0.022) and lower tumor location 5 cm or less from the anal verge (OR = 84.46, 95% CI 3.91-1822.85, p = 0.005) were independent factors for persistent AI. Conclusions: Anal incontinence may persist after restorative proctectomy in rectal cancer patients with high preoperative incontinence scores and lower tumor location. Therefore, this information should be provided when restorative proctectomy is offered for rectal cancer patients.

UR - http://www.scopus.com/inward/record.url?scp=80051574752&partnerID=8YFLogxK

U2 - 10.1007/s00268-011-1116-5

DO - 10.1007/s00268-011-1116-5

M3 - Article

C2 - 21519972

AN - SCOPUS:80051574752

VL - 35

SP - 1918

EP - 1924

JO - World journal of surgery

JF - World journal of surgery

SN - 0364-2313

IS - 8

ER -