Abstract

FONSECA GONZALEZ, Francisco Raúl; JIMENEZ BOBADILLA, Billy  and  VILLANUEVA HERRERO, Juan Antonio. Alterations of intestinal function and fecal continence after sphincter-preserving surgery due to rectal cancer. Cir. gen [online]. 2012, vol.34, n.4, pp.237-242. ISSN 1405-0099.

Objective: To assess the degree of severity of the low anterior resection syndrome (LARS) in patients after sphincter preserving surgery (SPS). Setting: Coloproctology unit of the General Hospital of Mexico ''Dr. Eduardo Liceaga'' (Third level health care hospital). Design: Cross-sectional cohort descriptive study. Statistical analysis: Percentages as summary measure for qualitative variables. Patients and methods: The study included 20 patients subjected to sphincter preserving surgery, from January 2007 to December 2011. These patients were evaluated according to the five-parameter LARS scale of the Aarhus University Hospital, in Denmark. We assessed prevalence of low anterior resection syndrome, intensity based on time and distance of the tumor from the anal margin. Results: Of the patients, 60% coursed with the low anterior resection syndrome with an average follow-up of 20 months. Incontinence to liquids was present in 48%, fragmented defecation in 21%, urgency to defecate in 17%; the other two assessed parameters were practically inexistent. The most severe degree of low anterior resection syndrome was seen in the first 8 months after surgery and only one patient, after 24 months of the surgery, continued with severe symptoms. Patients with tumors between 7 and 10 cm from the anal margin did not develop the assessed alterations or they were very mild. All patients with a tumor at less than 7 cm developed severe alterations. Conclusion: The most frequently found alterations were fecal incontinence to liquids, fragmented defecation, and urgency to defecate. The alterations assessed by the LARS scale were severe during the first months after surgery and when the tumor was closer to the anal margin.

Keywords : Low anterior resection syndrome; rectal cancer; fecal incontinence; quality of life.

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