efficacy of stimulation of the efferent loop and rehabilitation of the pelvic floor in the quality of life of patients who underwent anterior resection of the rectum (enesp): randomized clinical trial

Conditions: Rectal Cancer

Summary: many of the patients operated with sphincter preservation will present an alteration of bowel function and defecation. this dysfunction is variable in its symptoms and severity, and manifests itself in the form of urgency, incontinence and fragmentation of faeces, with repeated, incomplete or difficult evacuations. the set of these symptoms constitutes what is known as anterior resection syndrome (ars), which can negatively influence the quality of life of the operated patients and constitutes the main objective of the study to be investigated. from this study, the investigators want to evaluate the efficacy of stimulation of the efferent loop prior to the closure of the ileostomy along with rehabilitation of the pelvic floor after the closure of the ileostomy, in the quality of life of patients who underwent anterior resection of the rectum. a non-pharmacological randomized clinical trial will be conducted, comparing a control group (usual clinical practice), with respect to the experimental group where stimulation of the efferent loop will be performed prior to the closure of the ostomy along with pelvic floor rehabilitation after the closure of the latter. the main dependent variable will be the quality of life evaluated according to the qlq cr-29 questionnaire, and secondary dependent variables will be evaluated postoperative paralytic ileus and the previous resection syndrome using the lars scale.

many of the patients operated with sphincter preservation will present an alteration of bowel function and defecation. this dysfunction is variable in its symptoms and severity, and manifests itself in the form of urgency, incontinence and fragmentation of faeces, with repeated, incomplete or difficult evacuations. the set of these symptoms constitutes what is known as anterior resection syndrome (ars), which can negatively influence the quality of life of the operated patients and constitutes the main objective of the study to be investigated. from this study, the investigators want to evaluate the efficacy of stimulation of the efferent loop prior to the closure of the ileostomy along with rehabilitation of the pelvic floor after the closure of the ileostomy, in the quality of life of patients who underwent anterior resection of the rectum. a non-pharmacological randomized clinical trial will be conducted, comparing a control group (usual clinical practice), with respect to the experimental group where stimulation of the efferent loop will be performed prior to the closure of the ostomy along with pelvic floor rehabilitation after the closure of the latter. the main dependent variable will be the quality of life evaluated according to the qlq cr-29 questionnaire, and secondary dependent variables will be evaluated postoperative paralytic ileus and the previous resection syndrome using the lars scale.

Eligibility criteria:
inclusion criteria: * patients undergoing scheduled rectal cancer surgery, carriers of a protective ileostomy with a scheduled surgery date for ileostomy closure * patients over 18 years of age * patients with absence of cognitive deficit (pfeiffer: 0-2 errors) * patients who agree to participate in the study and sign the informed consent exclusion criteria: * end ileostomy patients * patients with active treatment of qt or rt * patients with some stoma complication such as mucosal prolapse or peristomal hernia * patients with fecal incontinence prior to anterior rectal resection surgery (wexner scale: greater than 3 points) * patients who do not agree to participate in the study * patients with cognitive deficit

Keywords: rectal cancer ileostomy quality of life anterior resection syndrome