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The influence of perineural invasion on anal incontinence in postoperative rectal cancer cases by Wexner Score

  • Firah Diyansah ,
  • Tomy Lesmana ,
  • Alphania Rahniayu ,
  • Edwin Danardono ,
  • Denny Septarendra ,

Abstract

Introduction: Rectal cancer is the third most common cancer globally. It is often treated with a Low Anterior Resection (LAR) procedure to avoid permanent colostomy. However, LAR can cause Low Anterior Resection Syndrome (LARS), impacting around 80-90% of patients and resulting in issues like anal incontinence. Our study delves into the connection between Perineural Invasion (PNI) and anal incontinence in postoperative rectal cancer cases following LAR, considering the significant impact of PNI on nerve function and the prevalence of anal incontinence in LARS cases. This study aims to explore the relationship between PNI and anal incontinence in postoperative rectal cancer cases following LAR.

Methods: This cross-sectional study examines the correlation between postoperative anal incontinence and PNI in a defined participant group chosen based on specific criteria. The study centers on rectal cancer patients who underwent LAR surgery, including those with and without perineural invasion, drawing data from Dr. Soetomo Surabaya Hospital records spanning January 2020 to December 2022.

Results: Characteristics of subjects, considering age and gender, were analyzed to ensure no differences exist between the negative and positive perineural invasion groups. Statistical analyses show similarities in age distribution (p=0.279) and gender distribution (p=1.000) between these groups. Chi-square analysis reveals a significant relationship between perineural invasion and cell differentiation grading (p=0.035). A significantly lower Wexner score was also found in the PNI negative group than in the PNI positive group (p=0.021).

Conclusion: A significant correlation was found between PNI, cell differentiation grading, and Wexner score. PNI-positive patients are likely to have incontinence compared with PNI-negative patients.

References

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How to Cite

Diyansah, F., Lesmana, T., Rahniayu, A., Danardono, E., & Septarendra, D. (2024). The influence of perineural invasion on anal incontinence in postoperative rectal cancer cases by Wexner Score. Bali Medical Journal, 13(1), 552–554. https://doi.org/10.15562/bmj.v13i1.5013

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