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Level of vascular tie and its effect on functional outcome 2 years after anterior resection for rectal cancer
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.ORCID iD: 0000-0003-4958-6965
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
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2017 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 19, no 11, p. 987-995Article in journal (Refereed) Published
Abstract [en]

Aim Previous research indicates that high tie of the inferior mesenteric artery during anterior resection for rectal cancer might be associated with an increased risk of postoperative functional disturbances. The goal of this population-based retrospective cohort study was to further investigate that association.

Method Patients who underwent anterior resection for rectal cancer from April 2011 to September 2012 were identified through the Swedish Colorectal Cancer Registry. Bowel and urogenital function were assessed by a postal questionnaire 2 years after surgery. Information on the level of mesenteric tie and clinical variables was retrieved from the registry. The outcome was defined as any defaecatory, urinary or sexual dysfunction as reported by the patient. The association between high tie and the outcome was evaluated with multivariable logistic and linear regression with adjustment for confounders, such as sex, body mass index, comorbidity and preoperative radiation.

Results With a response rate of 86%, 805 patients were included in the study. Of these, 46% were operated with high tie. After adjustment for confounders, high tie did not affect the risk of faecal incontinence (OR 0.85; 95% CI 0.59-1.22), urinary incontinence (OR 0.94; 95% CI 0.63-1.41) or various aspects of sexual dysfunction (erectile dysfunction, anejaculation, dyspareunia and coital vaginal dryness). However, an association between high tie and defaecation at night was detected (OR 1.44; 95% CI 1.02-2.03).

Conclusion This study does not support that the level of vascular tie influences the risk of major defaecatory, urinary or sexual disturbances 2 years after anterior resection for rectal cancer.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017. Vol. 19, no 11, p. 987-995
Keywords [en]
Autonomic function, ligation level, faecal incontinence, urinary incontinence, sexual function
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:umu:diva-141980DOI: 10.1111/codi.13745ISI: 000414180900010PubMedID: 28544473OAI: oai:DiVA.org:umu-141980DiVA, id: diva2:1163241
Available from: 2017-12-06 Created: 2017-12-06 Last updated: 2018-06-09Bibliographically approved

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Kverneng Hultberg, DanielRutegård, JörgenHaapamäki, Markku M.Rutegård, Martin

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