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

대한대장항문학회지 2014년 30권 3호 p.109 ~ 114
 ( Visser Wilhelmina S ) - St. Antonius Hospital Department of Surgery

 ( Riele Wouter W te ) - St. Antonius Hospital Department of Surgery
 ( Boerma Djamila ) - St. Antonius Hospital Department of Surgery
 ( Ramshorst Bert van ) - St. Antonius Hospital Department of Surgery
 ( Westreenen Henderik L van ) - Isala Clinics Department of Surgery


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.


Rectal neoplasms;Fecal incontinence;Pelvic floor
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