Bowel Function After Oncologic Resection for Colon Cancer: The Colon Does Not Matter
*Srinivas Joga Ivatury, *Lauren R. Wilson, *Matthew Z. Wilson
Dartmouth Hitchcock, Lebanon, NH
Objective: The objective is to evaluate the effect of elective oncologic resection for colon neoplasms on bowel function patient reported outcomes (PRO). Null hypothesis: Elective oncologic resection for colon neoplasm has no effect on bowel function PRO.
Design: Prospective observational study
Setting: Academic, tertiary referral center
Patients: Age≥18 with new diagnosis of non-metastatic colon neoplasm from 2016-2018 undergoing elective oncologic resection with primary anastomosis
Interventions: COREFO (COloREctal Functional Outcome Questionnaire) completion at baseline, postoperative follow-up, and any subsequent follow-up. Scale: 0 to 100. Higher score indicates worse function. Score>15 indicates symptomatology
Main Outcome Measures: Mean Total COREFO score and domain scores (Frequency, Incontinence, Stool-Related Aspects, Social Impact, and Need for Medication). Paired t-test
Results: 54 patients included. 26 (48%) women. Mean (SD) age: 62(15) years. 30 right-sided (proximal to splenic flexure) and 24 left-sided colon neoplasms. Minimally-invasive resection in 52 (96%). Stage distribution: 0 - 11, I - 13, II - 16, III - 14. Median (IQR) time between baseline and postoperative questionnaires: 55 (49-69) days. Mean frequency score increased following resection (Baseline: 10, Postoperative: 16; p=0.01). No difference in Total COREFO score or any other domain from baseline to postoperative follow-up. 11 had subsequent follow-up. Median (IQR) time between baseline and subsequent follow-up questionnaires: 266 (205-306) days. No difference in total score or any domain from baseline to subsequent follow-up.
Conclusions: Global bowel function and most bowel function PRO do not change following elective oncologic resection for colon neoplasms. Bowel movement frequency increases in the postoperative period but returns to baseline within a year.