Title: Treatment options to improve anorectal function following rectal resection: a systematic review
Authors: Maris, Anneleen *
Devreese Annemie, Anna Marie * ×
D'Hoore, André
Penninckx, Freddy
Staes, Filip #
Issue Date: Feb-2013
Publisher: Blackwell Science
Series Title: Colorectal Disease vol:15 issue:2 pages:67-78
Article number: 23017030
Abstract: Aim:€‚ Common problems after rectal resection are loose stools, faecal incontinence, increased frequency and evacuation difficulties, for which there are various therapeutic options. A systematic review was conducted to assess the outcome of treatment options aimed to improve anorectal function after rectal surgery. Method:€‚ Publications including a therapeutic approach to improve anorectal function after rectal surgery were searched using the following databases: MEDLINE, PubMed, EMBASE, Pedro, CINAHL, Web of Science, PsychInfo and the Cochrane Library. The focus was on outcome parameters of symptomatic improvement of faecal incontinence, evaluation of defaecation and quality of life. Results  The degree of agreement on eligibility and methodological quality between reviewers calculated with kappa was 0.85. Fifteen studies were included. Treatment options included pelvic floor re-education (n = 7), colonic irrigation (n €ƒ= €ƒ2) and sacral nerve stimulation (SNS) (n €ƒ= €ƒ6). Nine studies reported reduced incontinence scores and a decreased number of incontinent episodes. In 10 studies an improvement in resting and squeeze pressure was observed after treatment with pelvic floor re-education or SNS. Three studies reported improved quality of life after pelvic floor re-education. Significant improvement of the Fecal Incontinence Quality of Life Scale was found in three studies after SNS. Conclusion  Conservative therapies such as pelvic floor re-education and colonic irrigation can improve anorectal function. SNS might be an effective solution in selected patients. However, methodologically qualitative studies are limited and randomized controlled trials are needed to draw evidence-based conclusions.

© 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.
ISSN: 1462-8910
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Research Group for Neuromotor Rehabilitation
Research Group for Musculoskeletal Rehabilitation
Abdominal Surgical Oncology
* (joint) first author
× corresponding author
# (joint) last author

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