A word of caution in the functional monitoring of patients after rectal cancer surgery: a multicentre observational study.

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Techniques in Coloproctology Pub Date : 2025-01-04 DOI:10.1007/s10151-024-03089-w

P Planellas, N Fernandes-Montes, T Golda, S Alonso-Gonçalves, G Elorza, J Gil, E Kreisler, M R Abad-Camacho, L Cornejo, F Marinello

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Abstract

Background: Patients with rectal cancer often experience adverse effects on urinary, sexual, and digestive functions. Despite recognised impacts and available treatments, they are not fully integrated into follow-up protocols, thereby hindering appropriate interventions. The aim of the study was to discern the activities conducted in our routine clinical practice outside of clinical trials.

Methods: This multicentre, retrospective cohort study included consecutive patients undergoing rectal cancer surgery between January 2016 and January 2020 at six tertiary Spanish hospitals.

Results: A total of 787 patients were included. Two years post surgery, gastrointestinal evaluation was performed in 86% of patients. However, bowel movements per day were only recorded in 242 patients (46.4%), and the values of the Low Anterior Resection Syndrome (LARS) questionnaire were recorded in 106 patients (20.3%); 146 patients received a diagnosis of fecal incontinence (28.2%), while 124 patients were diagnosed with low anterior resection syndrome (23.8%). Urogenital evaluation was recorded in 21.1% of patients. Thirty-seven patients (5.1%) were detected to have urinary dysfunction, while 40 patients (5.5%) were detected to have sexual dysfunction. A total of 320 patients (43.9%) had their quality of life evaluated 2 years after surgery, and only 0.8% completed the Quality of Life questionnaire. Medication was the most used treatment for sequelae (26.9%) followed by referral to other specialists (15.1%).

Conclusions: There is a significant deficit in clinical follow-ups regarding the functional assessment of patients undergoing rectal cancer surgery. It is crucial to implement a postoperative functional follow-up protocol and to utilize technologies such as Patient-Reported Outcome Measures (PROMs) to enhance the evaluation and treatment of these sequelae, thereby ensuring an improved quality of life for patients.

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对直肠癌术后患者功能监测的警告：一项多中心观察性研究。

背景：直肠癌患者经常出现泌尿、性功能和消化功能的不良反应。尽管有公认的影响和现有的治疗方法，但它们没有完全纳入后续方案，从而阻碍了适当的干预措施。该研究的目的是辨别在临床试验之外的日常临床实践中进行的活动。方法：这项多中心、回顾性队列研究纳入了2016年1月至2020年1月在西班牙6家三级医院连续接受直肠癌手术的患者。结果：共纳入患者787例。术后两年，86%的患者进行了胃肠道评估。然而，只有242名患者（46.4%）记录了每天的排便，106名患者（20.3%）记录了低前切除术综合征（LARS）问卷的值；146例诊断为大便失禁（28.2%），124例诊断为低位前切除术综合征（23.8%）。21.1%的患者进行了泌尿生殖系统评估。尿功能障碍37例（5.1%），性功能障碍40例（5.5%）。共有320例患者（43.9%）在术后2年进行了生活质量评估，仅0.8%的患者完成了生活质量问卷。药物治疗是治疗后遗症最常用的方法（26.9%），其次是转诊（15.1%）。结论：直肠癌手术患者的功能评估在临床随访中存在明显缺陷。实施术后功能随访方案和利用诸如患者报告结果测量（PROMs）等技术来加强这些后遗症的评估和治疗是至关重要的，从而确保患者的生活质量得到改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.