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Title: | The Role of Pelvic Floor Muscle Training on Low Anterior Resection Syndrome A Multicenter Randomized Controlled Trial | Authors: | Asnong, Anne D'Hoore, Andre Van Kampen, Marijke Wolthuis, Albert Van Molhem, Yves Van Geluwe, Bart Devoogdt, Nele De Groef, An Fajardo, Ipek Guler Caamano GULER CAAMANO FAJARDO, Ipek |
Issue Date: | 2022 | Publisher: | LIPPINCOTT WILLIAMS & WILKINS | Source: | ANNALS OF SURGERY, 276 (5) , p. 761 -768 | Abstract: | Background and Objective: Total mesorectal excision (TME) for rectal cancer (RC) often results in significant bowel symptoms, commonly known as low anterior resection syndrome (LARS). Although pelvic floor muscle training (PFMT) is recommended in noncancer populations for treating bowel symptoms, this has been scarcely investigated in RC patients. The objective was to investigate PFMT effectiveness on LARS in patients after TME for RC. Methods: A multicenter, single-blind prospective randomized controlled trial comparing PFMT (intervention; n=50) versus no PFMT (control; n=54) 1 month following TME/stoma closure was performed. The primary endpoint was the proportion of participants with an improvement in the LARS category at 4 months. Secondary outcomes were: continuous LARS scores, ColoRectal Functioning Outcome scores, Numeric Rating Scale scores, stool diary items, and Short Form 12 scores; all assessed at 1, 4, 6, and 12 months. Results: The proportion of participants with an improvement in LARS category was statistically higher after PFMT compared with controls at 4 months (38.3% vs 19.6%; P=0.0415) and 6 months (47.8% vs 21.3%; P=0.0091), but no longer at 12 months (40.0% vs 34.9%; P=0.3897). Following secondary outcomes were significantly lower at 4 months: LARS scores (continuous, P=0.0496), ColoRectal Functioning Outcome scores (P=0.0369) and frequency of bowel movements (P=0.0277), solid stool leakage (day, P=0.0241; night, P=0.0496) and the number of clusters (P=0.0369), derived from the stool diary. No significant differences were found for the Numeric Rating Scale/quality of life scores. Conclusions: PFMT for bowel symptoms after TME resulted in lower proportions and faster recovery of bowel symptoms up to 6 months after surgery/stoma closure, justifying PFMT as an early, first-line treatment option for bowel symptoms after RC. | Notes: | Geraerts, I (corresponding author), KU Leuven Univ Leuven, Dept Rehabil Sci, Leuven, Belgium. inge.geraerts@kuleuven.be |
Keywords: | bowel symptoms;low anterior resection syndrome;pelvic floor muscle training;randomized controlled trial;rectal cancer | Document URI: | http://hdl.handle.net/1942/38830 | ISSN: | 0003-4932 | e-ISSN: | 1528-1140 | DOI: | 10.1097/SLA.0000000000005632 | ISI #: | 000864836700068 | Rights: | 2022 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2023 |
Appears in Collections: | Research publications |
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