1. Functional Outcomes of Patients Treated with Intensive Medications for Bowel and Pain Control for Low-Lying Rectal Cancer Who Received Preoperative Chemoradiotherapy
- Author
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Kimura Fumihiko, Naohiro Tomita, Naoki Yamanaka, Hidenori Yanagi, Nagahide Matsubara, Naohito Beppu, Doi Hiroshi, and Kamikonya Norihiko
- Subjects
Diarrhea ,Male ,medicine.medical_specialty ,Colorectal cancer ,Visual analogue scale ,Acrylic Resins ,Rectum ,Loperamide ,Preoperative care ,03 medical and health sciences ,0302 clinical medicine ,Preoperative Care ,Surgical Stapling ,medicine ,Oxycodone hydrochloride ,Humans ,Antidiarrheals ,Defecation ,Aged ,Pain, Postoperative ,Rectal Neoplasms ,business.industry ,Anastomosis, Surgical ,Gastroenterology ,Chemoradiotherapy, Adjuvant ,Middle Aged ,medicine.disease ,Neoadjuvant Therapy ,Surgery ,Analgesics, Opioid ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Anesthesia ,Female ,030211 gastroenterology & hepatology ,business ,Oxycodone ,Chemoradiotherapy ,medicine.drug - Abstract
Purpose: The aim of this study was to assess the functional outcomes of patients treated with intensive medications for bowel and pain control for low-lying rectal cancer who received preoperative chemoradiotherapy (CRT). Methods: The inclusion criterion was sphincter-preserving surgery following CRT for T3 middle and low rectal cancer. Postoperative defecation control was conducted using calcium polycarbophil and loperamide, and anal pain control was conducted using oxycodone hydrochloride hydrate. The functional outcomes were determined by an annual questionnaire after stoma closure. Results: Of 64 patients evaluated, 33 were reconstructed using the double stapling technique (DST) and 31 were reconstructed using the intersphincteric resection (ISR) technique. The median Visual Analogue Scale at ISR was improved from 7 to 1.5 at 1 year after surgery. The median Wexner scores were 6.0, 6.0, 5.0 and 5.0 for DST and 14.5, 12.0, 10.0 and 8.0 for ISR for the first 4 years, respectively. The only independent predictor of a poor bowel function (Wexner score >10) according to a multivariate analyses was pelvic infection (OR 3.994, 95% CI 1.235-13.52, p = 0.021), while ISR was not a predictor. Conclusions: Anal pain following ISR can be controlled with oxycodone hydrochloride hydrate therapy. ISR is feasible following CRT for low-lying rectal cancer.
- Published
- 2016