Bowel Dysfunction After Sphincter-saving Resection For Rectal Cancer

Objective The aim of this study was to investigate the incidence and factorsassociated withbowel dysfunction after sphincter-saving resection for rectalcancer.Methods For this study, standardized questionnaires were used to determinebowel function of patients, who underwent sphincter-saving resection for rectal cancerbetween January2006and September2011. Relevant clinical variables wereevaluated through Logistic regression analysis to predict risk factors of functionaloutcome.Results275patients completed questionnaires.33.8%patients haveboweldysfunction after sphincter-saving resection.Stool frequency was2.5per day (range0.25-13).Twenty-eight (28%) patients were incontinent,32(11.6%)were incontinentfor flatus,65(23.6%) were incontinent for liquid and47(17.1%) were incontinent forsolid stool.20(7.3%) patients had constipation,14patients took antidiarrheal,12patients need a laxative.Univariate analysis showed three variables to be significantlyassociated with the functional results：neoadjuvantchemoradiotherapy,distance fromthe tumor to the anal verge and temporary colostomy.Multivariateanalysis showed thatneoadjuvantchemoradiotherapy（OR=3.35，95%CI：1.63-6.87， P=0.001） andintersphincteric resection（ISR）（OR=5.22，95%CI：1.57-17.43，P=0.007）independently influenced functional results. Conclusion About one of three patientshavebowel dysfunction after sphincter-saving resection. Anal incontinence is a majorproblem following sphincter-saving resection. Neoadjuvantchemoradiotherapy andISR are independently associated with anal incontinence after sphincter-savingresection.