Functional outcomes and quality of life in patients with anterior resection for rectal cancer. Does preoperative manometry predict the feasibility of a J-pouch?

• Published in: Il Giornale di chirurgia 2004-04, Vol.25 (4), p.117-120
• Main Authors: Franco, S, Foresta, G, Cordio, S, Marletta, F, Lodin, M, Marino, G, Giannone, G
• Format: Article
• Language: Italian
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy, Adjuvant; Colonic Pouches; Female; Humans; Male; Manometry; Neoadjuvant Therapy; Predictive Value of Tests; Quality of Life; Radiotherapy Dosage; Radiotherapy, Adjuvant; Rectal Neoplasms - drug therapy; Rectal Neoplasms - physiopathology; Rectal Neoplasms - radiotherapy; Rectal Neoplasms - surgery; Surveys and Questionnaires; Treatment Outcome
• ISSN: 0391-9005

The goal in the treatment of rectal cancer is the recovery of the disease with the best fecal continence and quality of life. The Authors compared quality of life and manometric results in patients treated with neo-adjuvant chemotherapy and rectal low anterior resection (LRA). From January 1998 to March 2002 50 patients with advanced (T3-T4) rectal cancer underwent neo-adjuvant chemotherapy. Subsequently 41 of them underwent LRA with colon pouch (19) or without the pouch (22). After few months the quality of life was evaluated through a questionnaire. Later they underwent manometric evaluation measuring resting, squeeze and rectal compliance. The manometric results and the questionnaire scores agreed in 75% of patients. In detail, patients with hypotonic sphincter had a better (one could say good) quality of life if a LAR with pouch had been performed respect to the patients without pouch. Performing LAR with colon pouch after neoadjuvant chemotherapy in patients with hypotonic sphincter improves quality of life. Preoperative anorectal manometry could select patient who would benefit from pouch construction.