Functional outcome following low anterior resection with total mesorectal excision in the elderly

Background and aims: Disturbance of bowel function is not uncommon following low anterior resection, but the effect of low anterior resection on the elderly has seldom been documented. This study investigated the functional outcome in elderly patients following low anterior resection for carcinoma of the rectum. Patients and methods: The study included 87 patients with carcinoma of middle and lower rectum who underwent curative low anterior resection with total mesorectal excision and remained alive without recurrence for at least 6 months following the resection or closure of stoma. Anorectal manometry and questionnaire survey of the patients' bowel function were performed during follow-up (median 24.1 months) to investigate the functional outcome after surgery. Results: The median number of bowel motions was 2.5 per day in both elderly and young patients. Complete continence was achieved in 71.3% of patients, with both elderly and young patients performing similarly. The most common symptoms were clustering of bowel motions and urgency, which occurred in 30.3% and 34.9% of patients respectively, regardless of age. Manometric findings were also similar between the elderly and their younger counterparts. Conclusion: Bowel function and manometric findings following low anterior resection with total mesorectal excision in the elderly are not worse than in younger patients.