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The risk of long-term bowel dysfunction after resection for sigmoid adenocarcinoma: a cross sectional survey comparing complete mesocolic excision with conventional surgery

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AIM: To investigate if complete mesocolic excision (CME) might carry a higher risk of bowel dysfunction and subsequent reduction in quality of life when compared with conventional resection.

METHOD: A cross-sectional questionnaire study based on data from a national survey regarding long-term bowel function and a population-based cohort study comparing CME (study group) with conventional resections (control group). 622 patients undergoing elective resections for stage I-III sigmoid adenocarcinoma at four university colorectal centres between June 2008 and December 2014 were eligible to receive the questionnaire in mid-November 2015. Primary outcomes were four or more bowel movements daily, nocturnal bowel movements, unproductive call to stool, obstructive sensation and impact of bowel function on quality of life (QOL).

RESULTS: 127 (69.0%) and 289 (66.0%) patients in the study and control groups respectively responded to the questionnaire after medians of 4.41 (IQR 2.50; 5.83) and 4.57 (3.15; 5.82) years respectively (p = 0.048). CME was not associated with: increased risk of four or more bowel movements daily (adjusted OR 1.14 (95% CI 0.59-2.14; p = 0.68)), nocturnal bowel movements (adjusted OR 1.31 (0.66-2.53; p = 0.43)), unproductive call to stool (adjusted OR 0.99 (0.54-1.77; p = 0.97)), or obstructive sensation (adjusted OR 1.01 (0.56-1.78; p = 0.96)). While one in five patients in both groups had moderate to severe impact of bowel function on QOL, there was no association to CME.

CONCLUSION: For patients with sigmoid cancer, CME is associated with neither higher risk of bowel dysfunction nor impaired QOL. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalColorectal Disease
Volume20
Issue number9
Pages (from-to)0256-0266
ISSN1462-8910
DOIs
Publication statusPublished - 2018

ID: 54747642