Project description
Summary
Worldwide, colorectal cancer is the second most common cancer in women and the third most common cancer in men and almost 40% of these tumours find their origin in the rectum. Debilitating functional consequences are common after surgery for rectal cancer (RC), despite low local recurrence rates and improved survival.
Therefore, greater emphasis on functional outcome improvement is necessary. This doctoral project put the spotlight on RC survivors and was designed to gain insights into the postsurgical functional aspects and influencing factors thereof. The main goal was to investigate the efficacy of PFMT on bowel complaints.The applicability of different measurement methods for the assessment of those bowel complaints was also studied. Furthermore, the evolution over time of urinary and sexual problems as well as the evolution of different levels of physical activity after surgery for RC were explored. Lastly, high resolution colon manometry was used to examine possible underlying pathophysiological differences in colonic motor patterns resulting in varying degrees of bowel complaints after rectal excision.
Theme(s): Pelvic Dysfunctions, Assessment, Treatment, Oncology
FWO-TBM
Partners
Prof. Inge Geraerts (Department of Rehabilitation Sciences, KU Leuven; Department of Physical Medicine and Rehabilitation, UZ Leuven)
Prof. André D'Hoore (Department of Oncology, KU Leuven; Department of Abdominal Surgery, UZ Leuven)
Dr. Anne Asnong (Department of Rehabilitation Sciences, KU Leuven)
Results
The results of this project contribute a better understanding of functional complaints after radical surgery for rectal cancer. Notwithstanding the plethora of research questions that remain to be explored to complete the missing pieces of the LARS-enigma, we now know that pelvic floor muscle training is a valuable first-line treatment option for bowel symptoms, early in the postoperative care pathway of rectal cancer patients. Besides, it was also demonstrated that the majority of improvement in LARS occurs within the first 6 months after surgery. Furthermore, aspects regarding the impact of rectal cancer treatment on urinary and sexual symptoms as well as physical activity levels should not be overlooked nor underestimated and should be an integral part of postoperative rehabilitation. Additionally, we found that the occurrence of more cyclic short antegrade motor patterns and less HAPC’s (from the proximal to the mid-colon) is more prevalent in patients with major LARS.
These findings help to understand the differences in pathophysiology in patients developing major
versus no/minor bowel complaints after TME for rectal cancer. We also found that additional clinical information
regarding the bowel symptoms of patients needs to be obtained from a stool diary.
Funding
FWO-TBM
Publications
Contact
inge.geraerts@kuleuven.be