Affiliation:
1. IRCCS Sacro Cuore Don Calabria Hospital
Abstract
Abstract
PurposeThe incidence of long-term complications after rectal surgery varies widely among studies, and data regarding functional sequelae after transanal surgery are lacking. The aim of this study is to describe the incidence and change over time of sexual, urinary and intestinal dysfunction in a single-center cohort, identifying independent predictors of dysfunction.MethodsA retrospective analysis of all rectal resections performed between March 2016 and March 2020 at our institution was conducted. Validated questionnaires were administered to assess postoperative function. Predictors of dysfunction were assessed by univariate and multivariate analysis. Latent class analysis was used to distinguish different risk profile classes. Results145 patients were included. Sexual dysfunction at 1 month rose to 37% for both sexes, whereas urinary dysfunction reached 34% in males only. A significant (p<0.05) improvement in urogenital function was observed between 1 and 6 months only. Intestinal dysfunction increased at 1 month, with no significant improvement between 1 and 12 months. Independent predictors of genitourinary dysfunction were postoperative urinary retention, pelvic collection and Clavien-Dindo score ³ III (p<0.05). Transanal surgery resulted an independent predictor of better function (p<0.05). Transanal approach, Clavien-Dindo score ³ III and anastomotic stenosis were independent predictors of higher LARS scores (p<0.05).ConclusionsMaximum dysfunction was found at 1 month after surgery. Improvement was earlier for sexual and urinary dysfunction, whereas intestinal dysfunction improved slower and depended on pelvic floor rehabilitation. Transanal approach was protective for urinary and sexual function, although associated with a higher LARS score. Prevention of anastomosis related complications resulted protective of postoperative function.
Publisher
Research Square Platform LLC
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