Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/124303
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Colonic transit in patients after anterior resection: prospective, comparative study using single-photon emission CT/CT scintigraphy |
Author: | Ng, K.-S. Russo, R. Gladman, M.A. |
Citation: | British Journal of Surgery, 2020; 107(5):567-579 |
Publisher: | John Wiley & Sons |
Issue Date: | 2020 |
ISSN: | 0007-1323 1365-2168 |
Statement of Responsibility: | K.-S. Ng, R. Russo, and M. A. Gladman |
Abstract: | BACKGROUND:Bowel dysfunction after anterior resection is well documented, but its pathophysiology remains poorly understood. No study has assessed whether postoperative variation in colonic transit contributes to symptoms. This study measured colonic transit using planar scintigraphy and single-photon emission CT (SPECT)/CT in patients after anterior resection, stratified according to postoperative bowel function. METHODS:Symptoms were assessed using the low anterior resection syndrome (LARS) score. Following gallium-67 ingestion, scintigraphy was performed at predefined time points. Nine regions of interest were defined, and geometric centre (GC), percentage isotope retained, GC velocity index and colonic half-clearance time (T½ ) determined. Transit parameters were compared between subgroups based on LARS score using receiver operating characteristic (ROC) curve analyses. RESULTS:Fifty patients (37 men; median age 72·6 (range 44·4-87·7) years) underwent planar and SPECT scintigraphy. Overall, 17 patients had major and nine had minor LARS; 24 did not have LARS. There were significant differences in transit profiles between patients with major LARs and those without LARS: GCs were greater (median 5·94 (range 2·35-7·72) versus 4·30 (2·12-6·47) at 32 h; P = 0·015); the percentage retained isotope was lower (median 53·8 (range 6·5-100) versus 89·9 (38·4-100) per cent at 32 h; P = 0·002); GC velocity indices were greater (median 1·70 (range 1·18-1·92) versus 1·45 (0·98-1·80); P = 0·013); and T½ was shorter (median 38·3 (17·0-65·0) versus 57·0 (32·1-160·0) h; P = 0·003). Percentage tracer retained at 32 h best discriminated major LARS from no LARS (area under curve (AUC) 0·828). CONCLUSION:Patients with major LARS had accelerated colonic transit compared with those without LARS, which may help explain postoperative bowel dysfunction in this group. The percentage tracer retained at 32 h had the greatest AUC value in discriminating such patients. |
Keywords: | Colon Rectum Humans Rectal Neoplasms Tomography, Emission-Computed, Single-Photon Gastrointestinal Transit Postoperative Period Prospective Studies ROC Curve Adult Aged Aged, 80 and over Middle Aged Female Male |
Rights: | © 2020 BJS Society Ltd |
DOI: | 10.1002/bjs.11471 |
Published version: | http://dx.doi.org/10.1002/bjs.11471 |
Appears in Collections: | Aurora harvest 8 Medicine publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
hdl_124303.pdf | Submitted version | 4.49 MB | Adobe PDF | View/Open |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.