Colonic J-Pouch or Straight Colorectal Reconstruction After Low Anterior Resection For Rectal Cancer: Impact on Quality of Life and Bowel Function: A Multicenter Prospective Randomized Study

Teresa Gavaruzzi, Ugo Pace, Francesca Giandomenico, Salvatore Pucciarelli, Francesco Bianco, Francesco Selvaggi, Angelo Restivo, Corrado Rosario Asteria, Emilio Morpurgo, Dajana Cuicchi, Elio Jovine, Diego Coletta, Giuseppe La Torre, Antonio Amato, Antonio Chiappa, Francesco Marchegiani, Daniela Rega, Silvia De Franciscis, Gianluca Pellino, Luigi ZorcoloLorella Lotto, Luigi Boccia, Gaya Spolverato, Gian Luca De Salvo, Paolo Delrio, Paola Del Bianco

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Patient-reported outcomes associated with different bowel reconstruction techniques following anterior resection for rectal cancer are still a matter of debate.OBJECTIVE: This study aimed to assess quality of life and bowel function in patients who underwent colonic J-pouch or straight colorectal anastomosis reconstruction after low anterior resection.DESIGN: Bowel function and quality of life were assessed within a multicenter randomized trial. Questionnaires were administered before the surgery (baseline) and at 6, 12, and 24 months after surgery.SETTINGS: Patients were enrolled by 19 centers. The enrollment started in October 2009 and was stopped in February 2016. The study was registered at www.clinicaltrials.gov (Identifier: NCT01110798).PATIENTS: Patients who underwent low anterior resection for primary mid-low rectal cancer and who were randomly assigned in a 1:1 ratio to receive either stapled colonic J-pouch or straight colorectal anastomosis were selected.MAIN OUTCOME MEASURES: The primary outcomes measured were quality of life and bowel function.RESULTS: Of the 379 patients who were evaluable, 312 (82.3%) completed the baseline, 259 (68.3%) the 6-month, 242 (63.9%) the 12-month, and 199 (52.5%) the 24-month assessment. Bowel functioning and quality of life did not significantly differ between arms for almost all domains. The total bowel function score, the urgency, and the stool fractionation scores significantly worsened after surgery and remained impaired over time in both arms (p
Original languageEnglish
Pages (from-to)1511-1523
Number of pages13
JournalDis. Colon Rectum
Volume63
Issue number11
DOIs
Publication statusPublished - Nov 1 2020

Keywords

  • Anastomosis
  • Surgical/adverse effects
  • Colon/physiopathology
  • Colonic Pouches/adverse effects
  • Colorectal Surgery/methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Postoperative Complications/etiology
  • Proctectomy/adverse effects
  • Reconstructive Surgical Procedures/adverse effects
  • Rectal Neoplasms/pathology

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