Exploring bowel dysfunction of patients following colorectal surgery: A cohort study

J Clin Nurs. 2019 May;28(9-10):1577-1584. doi: 10.1111/jocn.14757. Epub 2019 Jan 17.

Abstract

Aims and objectives: To examine changes in patients' bowel function and to compare patients' outcome among different operation and treatment after rectal resection.

Background: Anal-preserving surgery is the trend of treatment of colorectal cancer and bowel function after surgery needs to be concerned.

Design: Prospective cohort study.

Methods: A total of 38 patients with convenience sampling were recruited from a teaching hospital. The low anterior resection syndrome (LARS) score was used to assess bowel function disturbances before discharge and at 1 week, 1 month and 3 months after discharge. We followed the STROBE checklist to ensure rigour in our study.

Results: Approximately half of the patients experienced major LARS, including daily stool frequency of more than seven times and stool clustering at least once a week. The LARS scores observed at 1 month after discharge were significantly higher than those observed before discharge. Patients who received intersphincteric resection had higher LARS scores compared with those who received other surgeries. Furthermore, patients who underwent concurrent chemoradiotherapy, operation (OP) and chemotherapy had the highest LARS scores compared with those who underwent only an OP.

Conclusion: The patients experienced varied intestinal dysfunction after surgery based on their treatment plan and surgical method. Nurses should provide individualised health education for these patients.

Relevance to clinical practice: A health education booklet is recommended to educate patients about LARS symptoms and the techniques to adapt in their daily lives after surgery.

Keywords: bowel dysfunction; bowel surgery; cancer care; colorectal cancer.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anal Canal / surgery*
  • Cohort Studies
  • Colorectal Surgery / adverse effects*
  • Defecation
  • Digestive System Surgical Procedures / adverse effects*
  • Fecal Incontinence / etiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Prospective Studies
  • Rectal Neoplasms / surgery*
  • Rectum / surgery*
  • Surveys and Questionnaires