학술논문
Defecation disorder and anal function after surgery for lower rectal cancer in elderly patients.
Document Type
Academic Journal
Author
Korai T; Department of Surgery Surgical Oncology and Science Sapporo Medical University Sapporo Japan.; Akizuki E; Department of Surgery Surgical Oncology and Science Sapporo Medical University Sapporo Japan.; Okita K; Department of Surgery Surgical Oncology and Science Sapporo Medical University Sapporo Japan.; Nishidate T; Department of Surgery Surgical Oncology and Science Sapporo Medical University Sapporo Japan.; Okuya K; Department of Surgery Surgical Oncology and Science Sapporo Medical University Sapporo Japan.; Sato Y; Department of Surgery Surgical Oncology and Science Sapporo Medical University Sapporo Japan.; Hamabe A; Department of Surgery Surgical Oncology and Science Sapporo Medical University Sapporo Japan.; Ishii M; Department of Surgery Surgical Oncology and Science Sapporo Medical University Sapporo Japan.; Nobuoka T; Department of Surgery Surgical Oncology and Science Sapporo Medical University Sapporo Japan.; Takemasa I; Department of Surgery Surgical Oncology and Science Sapporo Medical University Sapporo Japan.
Source
Publisher: John Wiley & Sons, Inc Country of Publication: Japan NLM ID: 101718062 Publication Model: eCollection Cited Medium: Internet ISSN: 2475-0328 (Electronic) Linking ISSN: 24750328 NLM ISO Abbreviation: Ann Gastroenterol Surg Subsets: PubMed not MEDLINE
Subject
Language
English
Abstract
Aim: This study aims to investigate the association of patient age with defecation disorders and anal function after lower rectal cancer surgery.
Methods: We retrospectively reviewed the data of 141 consecutive patients with lower rectal cancer who underwent sphincter-preserving operation. The patients were classified into five categories by age thresholds at 65, 70, 75, 80, and 85 years, for disaggregate analysis. Anal manometry was used for measuring the maximum resting pressure, high-pressure zone, and maximum squeeze pressure. Anal manometry was performed preoperatively and at 3, 6, 9, and 12 months postoperatively. The Wexner and low anterior resection syndrome scores were assessed at 1, 3, 6, 9, and 12 months after rectal surgery or stoma closure for patients with ileostomy.
Results: The data of 117 patients were reviewed. No significant differences were found between the younger and elderly groups in any characteristics across the six age groups. The preoperative intra-anal pressures of the elderly patients were slightly lower than those of the younger patients; however, there was no significant difference in the course of postoperative intra-anal pressures. Defecation disorder, as measured by the Wexner and low anterior resection syndrome scores, improved significantly in elderly patients compared to younger patients.
Conclusion: There was no significant difference in the course of postoperative intra-anal pressures between the elderly and younger patients. However, defecation disorders in elderly patients significantly improved compared with younger patients. Sphincter-preserving operation can be a viable treatment option for active elderly patients.
Competing Interests: Conflict of interest: Authors declare no conflict of interest for this article. Ethical statements: The protocol for this research project has been approved by a suitably constituted Ethics Committee of Sapporo Medical University and it conforms to the provisions of the Declaration of Helsinki (Committee of Sapporo Medical University, Approval No. 312‐130). The requirement for informed consent was waived due to the retrospective nature of this study.
(© 2021 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.)
Methods: We retrospectively reviewed the data of 141 consecutive patients with lower rectal cancer who underwent sphincter-preserving operation. The patients were classified into five categories by age thresholds at 65, 70, 75, 80, and 85 years, for disaggregate analysis. Anal manometry was used for measuring the maximum resting pressure, high-pressure zone, and maximum squeeze pressure. Anal manometry was performed preoperatively and at 3, 6, 9, and 12 months postoperatively. The Wexner and low anterior resection syndrome scores were assessed at 1, 3, 6, 9, and 12 months after rectal surgery or stoma closure for patients with ileostomy.
Results: The data of 117 patients were reviewed. No significant differences were found between the younger and elderly groups in any characteristics across the six age groups. The preoperative intra-anal pressures of the elderly patients were slightly lower than those of the younger patients; however, there was no significant difference in the course of postoperative intra-anal pressures. Defecation disorder, as measured by the Wexner and low anterior resection syndrome scores, improved significantly in elderly patients compared to younger patients.
Conclusion: There was no significant difference in the course of postoperative intra-anal pressures between the elderly and younger patients. However, defecation disorders in elderly patients significantly improved compared with younger patients. Sphincter-preserving operation can be a viable treatment option for active elderly patients.
Competing Interests: Conflict of interest: Authors declare no conflict of interest for this article. Ethical statements: The protocol for this research project has been approved by a suitably constituted Ethics Committee of Sapporo Medical University and it conforms to the provisions of the Declaration of Helsinki (Committee of Sapporo Medical University, Approval No. 312‐130). The requirement for informed consent was waived due to the retrospective nature of this study.
(© 2021 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.)