Risk factors for faecal incontinence after rectal cancer treatment

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Abstract
Low anterior resection (LAR) may result in faecal incontinence. This study aimed to identify risk factors for long-term faecal incontinence after total mesorectal excision (TME) with or without preoperative radiotherapy (PRT). Between 1996 and 1999, patients with operable rectal cancer were randomized to TME with or without PRT. Eligible patients who underwent LAR were studied retrospectively at 2 years (399 patients) and 5 years (339) after TME. At 5 years after surgery faecal incontinence was reported by 61·5 per cent of patients who had PRT and 38·8 per cent of those who did not (P < 0·001). Excessive blood loss and height of the tumour were associated with long-term faecal incontinence, but only in patients treated with PRT. Faecal incontinence is likely to occur after PRT and TME, especially when the perineum is irradiated.
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Funding Information
  • Quality Assurance Fellowship
  • European Society of Surgical Oncology
  • Maag Lever Darm Stichting
  • (Dutch Digestive Diseases Foundation)