Long-term bowel function following delayed coloanal anastomosis: Analysis of a multicentric cohort study (GRECCAR)

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Colorectal Disease Pub Date : 2025-02-04 DOI:10.1111/codi.70013

Maxime K. Collard, Jean-Jacques Tuech, Charles Sabbagh, Amine Souadka, Jérome Loriau, Eric Rullier, Frédéric Marchal, Adeline Germain, Stéphane Benoist, Jean-Luc Faucheron, Gilles Manceau, Anne Dubois, Anaïs Laforest, Isabelle Sourrouille, Aurore Protat, Diane Mège, Zaher Lakkis, Michel Prudhomme, Simon Derieux, Mehdi Ouaissi, Aurélien Venara, Cécile Brigand, Bernard Lelong, Karine Pautrat, Leon Maggiori, Gil Lebreton, Philippe Rouanet, Marc Pocard, Emilie Duchalais, Quentin Denost, Yann Parc, Jérémie H. Lefevre, for the GRECCAR Group

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Abstract

Aim

Alteration of bowel function after delayed coloanal anastomosis (DCAA) might be a limitation to its utilization. Our aim was to assess the long-term bowel function of DCAA in a large multicentric cohort.

Method

All patients who underwent DCAA interventions at 29 GRECCAR-affiliated hospitals between 2010 and 2021 were retrospectively included. Low anterior resection syndrome (LARS) score or confection of a stoma due to poor bowel function was assessed in eligible patients. Good bowel function was defined by the preservation of bowel continuity with no LARS or a minor LARS.

Results

Among the 385 eligible patients to assess long-term bowel continuity, 63% (n = 243) responded to the questionnaire or had a definitive stoma because of poor bowel function. After a median follow-up of 32 months, good bowel function was reported by 60% (n = 146) of patients (with no LARS 36% and minor LARS 24%), whereas 40% of patients (n = 146) had a poor bowel function including major LARS (36%) and definitive stoma due to poor bowel function (4%). No variables tested were predictive of a poor bowel function after DCAA, including a history of pelvic radiotherapy (P = 0.722), salvage DCAA after failure of a previous anastomosis (P = 0.755), presence of a diverting stoma (P = 0.556), occurrence of an anastomotic leakage (P = 0.416) and time interval from the DCAA to the bowel function assessment (P = 0.350).

Conclusions

No LARS or minor LARS was reached for 60% of patients after DCAA. Less than 5% of patients received a definitive stoma due to a poor bowel function.

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延迟结肠肛管吻合术后的长期肠功能：一项多中心队列研究（grecar）分析

目的延迟结肠肛管吻合术（DCAA）术后肠功能的改变可能限制其应用。我们的目的是在一个大型多中心队列中评估DCAA的长期肠道功能。方法回顾性分析2010年至2021年在29家greccar附属医院接受DCAA干预的患者。在符合条件的患者中评估低前切除术综合征（LARS）评分或因肠功能不良而造口的形成。良好的肠道功能被定义为保持肠道连续性，无LARS或轻微LARS。结果在385名符合评估长期肠道连续性的患者中，63% （n = 243）的患者回答了问卷调查或由于肠道功能不良而有明确的造口。中位随访32个月后，60% （n = 146）患者的肠功能良好（无LARS 36%，轻度LARS 24%），而40% （n = 146）患者的肠功能较差，包括严重LARS（36%）和由于肠功能不良导致的终性造口（4%）。没有测试变量预测DCAA术后肠功能不良，包括盆腔放疗史（P = 0.722）、先前吻合失败后的补补性DCAA （P = 0.755）、转移造口的存在（P = 0.556）、吻合口漏的发生（P = 0.416）和DCAA至肠功能评估的时间间隔（P = 0.350）。结论DCAA术后60%患者无LARS或轻度LARS。由于肠功能不佳，只有不到5%的患者接受了最终造口术。

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

Colorectal Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

11.80%

发文量

406

审稿时长

1.5 months

期刊介绍： Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate. Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases. Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies. Note that the journal does not usually accept paediatric surgical papers.