Predictors of Fecal Incontinence and Related Quality of Life After a Total Mesorectal Excision With Primary Anastomosis for Patients With Rectal Cancer.
- Author:
Marieke S WALMA
1
;
Verena N N KORNMANN
;
Djamila BOERMA
;
Marnix A J DE ROOS
;
Henderik L VAN WESTREENEN
Author Information
- Publication Type:Original Article
- Keywords: Rectal neoplasms; Quality of life; Fecal incontinence; Ileostomy
- MeSH: Fecal Incontinence*; Humans; Ileostomy; Linear Models; Multivariate Analysis; Quality of Life*; Rectal Neoplasms*
- From:Annals of Coloproctology 2015;31(1):23-28
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: After total mesorectal excision (TME) with primary anastomosis for patients with rectal cancer, the quality of life (QoL) may be decreased due to fecal incontinence. This study aimed to identify predictors of fecal incontinence and related QoL. METHODS: Patients who underwent TME with primary anastomosis for rectal cancer between December 2008 and June 2012 completed the fecal incontinence quality of life scale (FIQoL) and Wexner incontinence score. Factors associated with these scores were identified using a linear regression analysis. RESULTS: A total of 80 patients were included. Multivariate analysis identified a diverting ileostomy (n = 58) as an independent predictor of an unfavorable outcome on the FIQoL subscale coping/behavior (P = 0.041). Ileostomy closure within and after 3 months resulted in median Wexner scores of 5.0 (interquartile range [IQR], 2.5-8.0) and 10.5 (IQR, 6.0-13.8), respectively (P < 0.001). The median FIQoL score was 15.0 (IQR, 13.1-16.0) for stoma closure within 3 months versus 12.0 (IQR, 10.5-13.9) for closure after 3 months (P = 0.001). CONCLUSION: A diverting ileostomy is a predictor for an impaired FIQoL after a TME for rectal cancer. Stoma reversal within 3 months showed better outcomes than reversal after 3 months. Patients with a diverting ileostomy should be informed about the impaired QoL, even after stoma closure.
