Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025
Long-term bowel function following delayed coloanal anastomosis: Analysis of a multicentric cohort study (GRECCAR).
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Collard Maxime K, Tuech Jean-Jacques, Sabbagh Charles, Souadka Amine, Loriau Jérome, Rullier Eric, Marchal Frédéric, Germain Adeline, Benoist Stéphane, Faucheron Jean-Luc, Manceau Gilles, Dubois Anne, Laforest Anaïs, Sourrouille Isabelle, Protat Aurore, Mège Diane, Lakkis Zaher, Prudhomme Michel, Derieux Simon, Ouaissi Mehdi, Venara Aurélien, Brigand Cécile, Lelong Bernard, Pautrat Karine, Maggiori Leon, Lebreton Gil, Rouanet Philippe, Pocard Marc, Duchalais Emilie, Denost Quentin, Parc Yann, Lefevre Jérémie H, GRECCAR Group
Аннотация
AIM: Alteration of bowel function after delayed coloanal anastomosis (DCAA) might be a limitation to its utilization. Our aim was to assess the long-term bowel function of DCAA in a large multicentric cohort.
METHOD: All patients who underwent DCAA interventions at 29 GRECCAR-affiliated hospitals between 2010 and 2021 were retrospectively included. Low anterior resection syndrome (LARS) score or confection of a stoma due to poor bowel function was assessed in eligible patients. Good bowel function was defined by the preservation of bowel continuity with no LARS or a minor LARS.
RESULTS: Among the 385 eligible patients to assess long-term bowel continuity, 63% (n = 243) responded to the questionnaire or had a definitive stoma because of poor bowel function. After a median follow-up of 32 months, good bowel function was reported by 60% (n = 146) of patients (with no LARS 36% and minor LARS 24%), whereas 40% of patients (n = 146) had a poor bowel function including major LARS (36%) and definitive stoma due to poor bowel function (4%). No variables tested were predictive of a poor bowel function after DCAA, including a history of pelvic radiotherapy (P = 0.722), salvage DCAA after failure of a previous anastomosis (P = 0.755), presence of a diverting stoma (P = 0.556), occurrence of an anastomotic leakage (P = 0.416) and time interval from the DCAA to the bowel function assessment (P = 0.350).
CONCLUSIONS: No LARS or minor LARS was reached for 60% of patients after DCAA. Less than 5% of patients received a definitive stoma due to a poor bowel function.
METHOD: All patients who underwent DCAA interventions at 29 GRECCAR-affiliated hospitals between 2010 and 2021 were retrospectively included. Low anterior resection syndrome (LARS) score or confection of a stoma due to poor bowel function was assessed in eligible patients. Good bowel function was defined by the preservation of bowel continuity with no LARS or a minor LARS.
RESULTS: Among the 385 eligible patients to assess long-term bowel continuity, 63% (n = 243) responded to the questionnaire or had a definitive stoma because of poor bowel function. After a median follow-up of 32 months, good bowel function was reported by 60% (n = 146) of patients (with no LARS 36% and minor LARS 24%), whereas 40% of patients (n = 146) had a poor bowel function including major LARS (36%) and definitive stoma due to poor bowel function (4%). No variables tested were predictive of a poor bowel function after DCAA, including a history of pelvic radiotherapy (P = 0.722), salvage DCAA after failure of a previous anastomosis (P = 0.755), presence of a diverting stoma (P = 0.556), occurrence of an anastomotic leakage (P = 0.416) and time interval from the DCAA to the bowel function assessment (P = 0.350).
CONCLUSIONS: No LARS or minor LARS was reached for 60% of patients after DCAA. Less than 5% of patients received a definitive stoma due to a poor bowel function.