Ann Coloproctol.  2014 Jun;30(3):109-114. 10.3393/ac.2014.30.3.109.

Pelvic Floor Rehabilitation to Improve Functional Outcome After a Low Anterior Resection: A Systematic Review

• Visser WS
• te Riele W
• Boerma D
• van Ramshorst B
• van Westreenen HL

• KMID: 1801627
• DOI: http://doi.org/10.3393/ac.2014.30.3.109

Abstract

PURPOSE
Impaired functional outcome is common after a low anterior resection (LAR). Pelvic floor rehabilitation (PFR) might improve functional outcome after a LAR. The aim of this systematic review is to evaluate the effectiveness of PFR in improving functional outcome.
METHODS
PubMed, Embase, and the Cochrane Library were searched using the terms fecal incontinence, colorectal neoplasm/surgery, LAR, rectal cancer, anterior resection syndrome, bowel habit, pelvic floor, training, therapy, physical therapy, rehabilitation and biofeedback. Of the 125 identified records, 5 articles were included.
RESULTS
The 5 included studies reported on 321 patients, of which 286 patients (89%) underwent pelvic floor training. Three studies included patients with anterior resection syndrome after a LAR while the remaining studies included a series of patients after a LAR. Functional outcome was mostly assessed by using the Wexner incontinence scale. Quality of life was assessed in one study, and in three studies, rectal manometry was performed. After PFR, the functional outcome was improved in four studies, as was the quality of life.
CONCLUSION
This systematic review demonstrated that PFR is useful for improving the functional outcome after a LAR. The data are extracted from studies of limited quality, but the available evidence points to the effectiveness of the procedure.

Keyword

Rectal neoplasms; Fecal incontinence; Pelvic floor

MeSH Terms

Biofeedback, Psychology
Fecal Incontinence
Humans
Manometry
Pelvic Floor*
Quality of Life
Rectal Neoplasms
Rehabilitation*