Effectiveness of Pelvic Floor Rehabilitation for Bowel Dysfunction After Intersphincteric Resection for Lower Rectal Cancer
Background The aim of this study was to evaluate the effectiveness of pelvic floor rehabilitation (PFR) for patients with bowel dysfunction after intersphincteric resection (ISR) and to compare the treatment response to that of patients after low anterior resection (LAR). Methods Thirty patients wit...
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| Veröffentlicht in: | World journal of surgery 2018-10, Vol.42 (10), p.3415-3421 |
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| creator | Nishigori, Hideaki Ishii, Masayuki Kokado, Yujiro Fujimoto, Kouji Higashiyama, Hiroshi |
| description | Background
The aim of this study was to evaluate the effectiveness of pelvic floor rehabilitation (PFR) for patients with bowel dysfunction after intersphincteric resection (ISR) and to compare the treatment response to that of patients after low anterior resection (LAR).
Methods
Thirty patients with postoperative bowel dysfunction for more than 6 months were enrolled and treated with PFR for 6 months.
Results
In the ISR group, significant improvements in the number of bowel movements and the use of antidiarrheal medications were observed, but no significant improvement was observed in the Wexner score (WS) and the fecal incontinence severity index (FISI). Meanwhile, in the LAR group, WS and FISI were better post-treatment than pre-treatment (WS: 10.7–5.7;
p
= 0.01, FISI: 28–11;
p
= 0.01). In the assessment of fecal incontinence quality of life (FIQL), only the Coping/Behavior category was improved in the ISR group (1.56 before, 2.16 after PFR;
p
= 0.01), while all four categories were improved significantly in the LAR group. The anorectal manometric examination showed no significant increase in sphincter pressure and the tolerable volume in patients after ISR.
Conclusions
PFR improved several clinical symptoms of patients after ISR. Compared with patients after LAR, patients after ISR showed an insufficient response to PFR in improving fecal incontinence. Considering the result of the generalized assessment of the quality of life scale, PFR may offer a therapeutic effect for several symptoms of patients after ISR. |
| doi_str_mv | 10.1007/s00268-018-4596-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2015840978</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2015840978</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4888-a12ce407835541ed6a90c25fd8d537b7b38f378e2d13c6bac85b8c4cec2b1b473</originalsourceid><addsrcrecordid>eNqFkUtv1DAUhS1ERYeBH8AGRWLDJsXPxFm2Q6ctGglUQCwtx7mmrjzxYCetRvx5nKYPCQmxsa2j85175YPQG4KPCMb1h4QxrWSJiSy5aKpSPkMLwhktKaPsOVpgVvH8JuwQvUzpGmNSV7h6gQ5pI0Qla7lAv0-tBTO4G-ghpSLY4gv4G2eKtQ8hFpdwpVvn3aAHF_rCZukk3IIvPu6THXtzpx7bAWJx0ecz7a5cViHmhEtIYB6xTcamPDNoX6x0byC-QgdW-wSv7-8l-r4-_bY6Lzefzy5Wx5vScCllqQk1wHEtmRCcQFfpBhsqbCc7weq2bpm0rJZAO8JM1WojRSsNN2BoS1pesyV6P-fuYvg1QhrU1iUD3usewpgUxURIjps8YYne_WW9DmPs83Z3Li5I_vDsIrPLxJBSBKt20W113CuC1dSMmptRuRk1NaMm5u198thuoXskHqrIhmY23DoP-_8nqh-fvp6ssWzkxNKZTRnrf0J8WvvfG_0BB9mrGg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2015451268</pqid></control><display><type>article</type><title>Effectiveness of Pelvic Floor Rehabilitation for Bowel Dysfunction After Intersphincteric Resection for Lower Rectal Cancer</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals - AutoHoldings</source><creator>Nishigori, Hideaki ; Ishii, Masayuki ; Kokado, Yujiro ; Fujimoto, Kouji ; Higashiyama, Hiroshi</creator><creatorcontrib>Nishigori, Hideaki ; Ishii, Masayuki ; Kokado, Yujiro ; Fujimoto, Kouji ; Higashiyama, Hiroshi</creatorcontrib><description>Background
The aim of this study was to evaluate the effectiveness of pelvic floor rehabilitation (PFR) for patients with bowel dysfunction after intersphincteric resection (ISR) and to compare the treatment response to that of patients after low anterior resection (LAR).
Methods
Thirty patients with postoperative bowel dysfunction for more than 6 months were enrolled and treated with PFR for 6 months.
Results
In the ISR group, significant improvements in the number of bowel movements and the use of antidiarrheal medications were observed, but no significant improvement was observed in the Wexner score (WS) and the fecal incontinence severity index (FISI). Meanwhile, in the LAR group, WS and FISI were better post-treatment than pre-treatment (WS: 10.7–5.7;
p
= 0.01, FISI: 28–11;
p
= 0.01). In the assessment of fecal incontinence quality of life (FIQL), only the Coping/Behavior category was improved in the ISR group (1.56 before, 2.16 after PFR;
p
= 0.01), while all four categories were improved significantly in the LAR group. The anorectal manometric examination showed no significant increase in sphincter pressure and the tolerable volume in patients after ISR.
Conclusions
PFR improved several clinical symptoms of patients after ISR. Compared with patients after LAR, patients after ISR showed an insufficient response to PFR in improving fecal incontinence. Considering the result of the generalized assessment of the quality of life scale, PFR may offer a therapeutic effect for several symptoms of patients after ISR.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-018-4596-8</identifier><identifier>PMID: 29556878</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Aged, 80 and over ; Anal Canal - surgery ; Anorectal ; Cancer ; Cardiac Surgery ; Colorectal cancer ; Fecal incontinence ; Fecal Incontinence - etiology ; Fecal Incontinence - physiopathology ; Fecal Incontinence - rehabilitation ; Feces ; Female ; General Surgery ; Humans ; Intestine ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Scientific Report ; Patients ; Pelvic Floor - physiopathology ; Postoperative Complications - physiopathology ; Postoperative Complications - rehabilitation ; Quality assessment ; Quality of Life ; Rectal Neoplasms - surgery ; Rectum ; Rehabilitation ; Retrospective Studies ; Sphincter ; Surgery ; Thoracic Surgery ; Treatment Outcome ; Vascular Surgery</subject><ispartof>World journal of surgery, 2018-10, Vol.42 (10), p.3415-3421</ispartof><rights>Société Internationale de Chirurgie 2018</rights><rights>2018 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4888-a12ce407835541ed6a90c25fd8d537b7b38f378e2d13c6bac85b8c4cec2b1b473</citedby><cites>FETCH-LOGICAL-c4888-a12ce407835541ed6a90c25fd8d537b7b38f378e2d13c6bac85b8c4cec2b1b473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-018-4596-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-018-4596-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,41464,42533,45550,45551,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29556878$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nishigori, Hideaki</creatorcontrib><creatorcontrib>Ishii, Masayuki</creatorcontrib><creatorcontrib>Kokado, Yujiro</creatorcontrib><creatorcontrib>Fujimoto, Kouji</creatorcontrib><creatorcontrib>Higashiyama, Hiroshi</creatorcontrib><title>Effectiveness of Pelvic Floor Rehabilitation for Bowel Dysfunction After Intersphincteric Resection for Lower Rectal Cancer</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
The aim of this study was to evaluate the effectiveness of pelvic floor rehabilitation (PFR) for patients with bowel dysfunction after intersphincteric resection (ISR) and to compare the treatment response to that of patients after low anterior resection (LAR).
Methods
Thirty patients with postoperative bowel dysfunction for more than 6 months were enrolled and treated with PFR for 6 months.
Results
In the ISR group, significant improvements in the number of bowel movements and the use of antidiarrheal medications were observed, but no significant improvement was observed in the Wexner score (WS) and the fecal incontinence severity index (FISI). Meanwhile, in the LAR group, WS and FISI were better post-treatment than pre-treatment (WS: 10.7–5.7;
p
= 0.01, FISI: 28–11;
p
= 0.01). In the assessment of fecal incontinence quality of life (FIQL), only the Coping/Behavior category was improved in the ISR group (1.56 before, 2.16 after PFR;
p
= 0.01), while all four categories were improved significantly in the LAR group. The anorectal manometric examination showed no significant increase in sphincter pressure and the tolerable volume in patients after ISR.
Conclusions
PFR improved several clinical symptoms of patients after ISR. Compared with patients after LAR, patients after ISR showed an insufficient response to PFR in improving fecal incontinence. Considering the result of the generalized assessment of the quality of life scale, PFR may offer a therapeutic effect for several symptoms of patients after ISR.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anal Canal - surgery</subject><subject>Anorectal</subject><subject>Cancer</subject><subject>Cardiac Surgery</subject><subject>Colorectal cancer</subject><subject>Fecal incontinence</subject><subject>Fecal Incontinence - etiology</subject><subject>Fecal Incontinence - physiopathology</subject><subject>Fecal Incontinence - rehabilitation</subject><subject>Feces</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Intestine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Scientific Report</subject><subject>Patients</subject><subject>Pelvic Floor - physiopathology</subject><subject>Postoperative Complications - physiopathology</subject><subject>Postoperative Complications - rehabilitation</subject><subject>Quality assessment</subject><subject>Quality of Life</subject><subject>Rectal Neoplasms - surgery</subject><subject>Rectum</subject><subject>Rehabilitation</subject><subject>Retrospective Studies</subject><subject>Sphincter</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkUtv1DAUhS1ERYeBH8AGRWLDJsXPxFm2Q6ctGglUQCwtx7mmrjzxYCetRvx5nKYPCQmxsa2j85175YPQG4KPCMb1h4QxrWSJiSy5aKpSPkMLwhktKaPsOVpgVvH8JuwQvUzpGmNSV7h6gQ5pI0Qla7lAv0-tBTO4G-ghpSLY4gv4G2eKtQ8hFpdwpVvn3aAHF_rCZukk3IIvPu6THXtzpx7bAWJx0ecz7a5cViHmhEtIYB6xTcamPDNoX6x0byC-QgdW-wSv7-8l-r4-_bY6Lzefzy5Wx5vScCllqQk1wHEtmRCcQFfpBhsqbCc7weq2bpm0rJZAO8JM1WojRSsNN2BoS1pesyV6P-fuYvg1QhrU1iUD3usewpgUxURIjps8YYne_WW9DmPs83Z3Li5I_vDsIrPLxJBSBKt20W113CuC1dSMmptRuRk1NaMm5u198thuoXskHqrIhmY23DoP-_8nqh-fvp6ssWzkxNKZTRnrf0J8WvvfG_0BB9mrGg</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Nishigori, Hideaki</creator><creator>Ishii, Masayuki</creator><creator>Kokado, Yujiro</creator><creator>Fujimoto, Kouji</creator><creator>Higashiyama, Hiroshi</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>201810</creationdate><title>Effectiveness of Pelvic Floor Rehabilitation for Bowel Dysfunction After Intersphincteric Resection for Lower Rectal Cancer</title><author>Nishigori, Hideaki ; Ishii, Masayuki ; Kokado, Yujiro ; Fujimoto, Kouji ; Higashiyama, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4888-a12ce407835541ed6a90c25fd8d537b7b38f378e2d13c6bac85b8c4cec2b1b473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anal Canal - surgery</topic><topic>Anorectal</topic><topic>Cancer</topic><topic>Cardiac Surgery</topic><topic>Colorectal cancer</topic><topic>Fecal incontinence</topic><topic>Fecal Incontinence - etiology</topic><topic>Fecal Incontinence - physiopathology</topic><topic>Fecal Incontinence - rehabilitation</topic><topic>Feces</topic><topic>Female</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Intestine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Scientific Report</topic><topic>Patients</topic><topic>Pelvic Floor - physiopathology</topic><topic>Postoperative Complications - physiopathology</topic><topic>Postoperative Complications - rehabilitation</topic><topic>Quality assessment</topic><topic>Quality of Life</topic><topic>Rectal Neoplasms - surgery</topic><topic>Rectum</topic><topic>Rehabilitation</topic><topic>Retrospective Studies</topic><topic>Sphincter</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nishigori, Hideaki</creatorcontrib><creatorcontrib>Ishii, Masayuki</creatorcontrib><creatorcontrib>Kokado, Yujiro</creatorcontrib><creatorcontrib>Fujimoto, Kouji</creatorcontrib><creatorcontrib>Higashiyama, Hiroshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nishigori, Hideaki</au><au>Ishii, Masayuki</au><au>Kokado, Yujiro</au><au>Fujimoto, Kouji</au><au>Higashiyama, Hiroshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of Pelvic Floor Rehabilitation for Bowel Dysfunction After Intersphincteric Resection for Lower Rectal Cancer</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2018-10</date><risdate>2018</risdate><volume>42</volume><issue>10</issue><spage>3415</spage><epage>3421</epage><pages>3415-3421</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
The aim of this study was to evaluate the effectiveness of pelvic floor rehabilitation (PFR) for patients with bowel dysfunction after intersphincteric resection (ISR) and to compare the treatment response to that of patients after low anterior resection (LAR).
Methods
Thirty patients with postoperative bowel dysfunction for more than 6 months were enrolled and treated with PFR for 6 months.
Results
In the ISR group, significant improvements in the number of bowel movements and the use of antidiarrheal medications were observed, but no significant improvement was observed in the Wexner score (WS) and the fecal incontinence severity index (FISI). Meanwhile, in the LAR group, WS and FISI were better post-treatment than pre-treatment (WS: 10.7–5.7;
p
= 0.01, FISI: 28–11;
p
= 0.01). In the assessment of fecal incontinence quality of life (FIQL), only the Coping/Behavior category was improved in the ISR group (1.56 before, 2.16 after PFR;
p
= 0.01), while all four categories were improved significantly in the LAR group. The anorectal manometric examination showed no significant increase in sphincter pressure and the tolerable volume in patients after ISR.
Conclusions
PFR improved several clinical symptoms of patients after ISR. Compared with patients after LAR, patients after ISR showed an insufficient response to PFR in improving fecal incontinence. Considering the result of the generalized assessment of the quality of life scale, PFR may offer a therapeutic effect for several symptoms of patients after ISR.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>29556878</pmid><doi>10.1007/s00268-018-4596-8</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Adult Aged Aged, 80 and over Anal Canal - surgery Anorectal Cancer Cardiac Surgery Colorectal cancer Fecal incontinence Fecal Incontinence - etiology Fecal Incontinence - physiopathology Fecal Incontinence - rehabilitation Feces Female General Surgery Humans Intestine Male Medicine Medicine & Public Health Middle Aged Original Scientific Report Patients Pelvic Floor - physiopathology Postoperative Complications - physiopathology Postoperative Complications - rehabilitation Quality assessment Quality of Life Rectal Neoplasms - surgery Rectum Rehabilitation Retrospective Studies Sphincter Surgery Thoracic Surgery Treatment Outcome Vascular Surgery |
| title | Effectiveness of Pelvic Floor Rehabilitation for Bowel Dysfunction After Intersphincteric Resection for Lower Rectal Cancer |
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