Evaluating transanal irrigation for alleviating symptoms of low anterior resection syndrome post rectal cancer surgery: A meta-analysis.

Abstract

Colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer-related death worldwide. Despite medical advances, approximately 80% of all rectal cancer survivors develop low anterior resection syndrome. Although transanal irrigation holds promise against low anterior resection syndrome, existing evidence is inconclusive. In this study, we evaluated the efficacy and safety of transanal irrigation in managing low anterior resection syndrome. Cochrane Library, PubMed, Embase, Chinese Electronic Periodical Services, and ClinicalTrials.gov were systematically searched for studies on transanal irrigation. Six studies involving 258 patients were included. Transanal irrigation significantly mitigated bowel symptom severity within 3, 6, and 12 months of treatment, with mean differences (95% confidence intervals) of -14.22 (-20.07 to -8.38, I² = 30%), -11.44 (-15.88 to -7.01, I² = 0%), and -9.01 (-13.01 to -5.02, I² = 0%), respectively. Transanal irrigation also significantly reduced fecal incontinence within 3, 6, and 12 months of treatment, with standardized mean differences (95% confidence intervals) of -0.91 (-1.59 to -0.23), -0.72 (-1.32 to -0.13, I² = 19%), and -0.64 (-1.14 to -0.14, I² = 0%), respectively. No significant between-group difference was observed in treatment satisfaction (mean difference: 1.12, 95% confidence interval: -0.41 to 2.65, I² = 28%) or quality of life. Transanal irrigation may offer short-term relief from low anterior resection syndrome symptoms after rectal cancer surgery, although its effects may diminish over time. However, it does not significantly contribute to quality of life or treatment satisfaction. Further research is required to determine the long-term outcomes of transanal irrigation.