Risk factors for faecal incontinence after rectal cancer treatment

Br J Surg. 2007 Oct;94(10):1278-84. doi: 10.1002/bjs.5819.


Background: Low anterior resection (LAR) may result in faecal incontinence. This study aimed to identify risk factors for long-term faecal incontinence after total mesorectal excision (TME) with or without preoperative radiotherapy (PRT).

Methods: Between 1996 and 1999, patients with operable rectal cancer were randomized to TME with or without PRT. Eligible patients who underwent LAR were studied retrospectively at 2 years (399 patients) and 5 years (339) after TME.

Results: At 5 years after surgery faecal incontinence was reported by 61.5 per cent of patients who had PRT and 38.8 per cent of those who did not (P < 0.001). Excessive blood loss and height of the tumour were associated with long-term faecal incontinence, but only in patients treated with PRT.

Conclusion: Faecal incontinence is likely to occur after PRT and TME, especially when the perineum is irradiated.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Fecal Incontinence / etiology*
  • Female
  • Humans
  • Intraoperative Care / methods
  • Male
  • Postoperative Complications / etiology*
  • Quality of Life
  • Rectal Neoplasms / radiotherapy
  • Rectal Neoplasms / surgery*
  • Risk Factors