Published online Sep 7, 2020. doi: 10.3748/wjg.v26.i33.4972
Peer-review started: March 27, 2020
First decision: May 21, 2020
Revised: May 29, 2020
Accepted: June 17, 2020
Article in press: June 17, 2020
Published online: September 7, 2020
Compared with bowel habit changes that occur after rectal resection or left-sided colectomy, bowel dysfunctions seen after right-sided colectomy are relatively mild and temporary and have not traditionally been considered a significant issue.
Since the concept of complete mesocolic excision has been introduced, suggesting that the risk of bowel dysfunction due to superior mesenteric nerve plexus transection has increased. But not many studies have been published on the topic of bowel dysfunction after right-sided colectomy.
The main aim of this study was to evaluate the functional outcomes of patients who underwent right-sided colectomy with D3 lymphadenectomy for colon cancer.
Functional data from patients who underwent minimally invasive right-sided colectomy with D3 lymph node dissection for colon cancer were prospectively collected. Questionnaire responses were conducted preoperatively and 3, 6, 12, and 18 mo after the operation. The assessment of quality of life (QOL) used version 3 of the European Organization for Research and Treatment of Cancer Core QOL Questionnaire C30. Bowel function was evaluated for the items of gas, stool leakage, frequency, fragmentation, and urgency.
Most scales of quality of life and bowel function improved significantly over time. Urgency persisted to a high degree throughout the period without a significant change over time. The use of medications for defecation was about 10% over the entire period. In patients taking medication, gas and fecal frequency increased, and bowel dysfunction group was more common. At six months, resected bowel and colon lengths were significant risk factor for bowel dysfunction.
Even with D3 lymphadenectomy for right-sided colon adenocarcinoma, patients receiving right-sided colectomy using a minimally invasive approach should not experience major bowel dysfunction, and most bowel symptoms improved over time. About 10% of patients were in constant need of medication after right-sided colectomy continuously.
Larger samples, long-term follow-up study including comparison group is needed to complement our findings. It is also better to use a more suitable bowel score as the tool to measure bowel function after right colectomy.