Pelvic floor rehabilitation improves anorectal function after sphincter-preserving surgery for low rectal cancer

Table 1 Baseline characteristics of study participants, n (%)/mean ± SD

Characteristic	Observation group (n = 52)	Control group (n = 48)
Age (years)	58.3 ± 10.5	59.7 ± 11.2
Male sex	33 (63.5)	29 (60.4)
BMI (kg/m2)	23.8 ± 3.2	24.1 ± 3.5
Tumor distance from anal verge (cm)	3.8 ± 1.2	3.6 ± 1.3
TNM stage
I	12 (23.1)	10 (20.8)
II	21 (40.4)	19 (39.6)
III	19 (36.5)	19 (39.6)
Neoadjuvant therapy	35 (67.3)	31 (64.6)
Time to stoma closure (months)	4.2 ± 1.1	4.5 ± 1.3

No significant differences were observed between groups for any baseline characteristic (all P > 0.05). BMI: Body mass index; TNM: Tumor-node-metastasis.

Table 2 Anorectal manometry parameters over time, mean ± SD

Parameter	Time point	Observation (n = 52)	Control (n = 48)
RAP (mmHg)	Baseline	48.5 ± 10.3	47.2 ± 11.1
	3 months	65.3 ± 8.7c	52.4 ± 9.2
	6 months	72.5 ± 7.8c	58.3 ± 8.5
MSP (mmHg)	Baseline	85.3 ± 18.5	83.7 ± 19.2
	3 months	128.5 ± 15.3c	98.7 ± 16.8
	6 months	145.2 ± 14.5c	112.3 ± 17.2

^cP < 0.001 vs control group at same time point.

RAP: Resting anal pressure; MSP: Maximum squeeze pressure.

Table 3 Functional outcomes and quality of life measures at 6 months, n (%)/mean ± SD

Outcome measure	Observation (n = 52)	Control (n = 48)
Wexner incontinence score	4.2 ± 1.8c	8.5 ± 2.3
Good continence (score ≤ 7)	38 (73.1)b	20 (41.7)
Time to normal defecation (days)	68.5 ± 12.3c	95.8 ± 18.5
Daily bowel frequency (times/day)	3.8 ± 1.2c	6.5 ± 2.1
Urgency	10 (19.2)c	25 (52.1)
FIQL total score (range 1-5)	4.1 ± 0.6c	3.2 ± 0.8
Patient satisfaction score (0-10)	8.3 ± 1.1c	6.1 ± 1.6

^bP < 0.01.

^cP < 0.001 vs control group.

FIQL: Fecal Incontinence Quality of Life Scale.

Table 4 Multivariate analysis of predictors for good continence at 6 months

Variable	Adjusted OR	95%CI	P value
Pelvic floor rehabilitation	8.73	3.15-24.18	< 0.001
Baseline MSP (per mmHg)	1.05	1.02-1.08	0.002
Tumor distance from anal verge (per cm)	1.42	1.08-1.87	0.012
Age (per year)	0.97	0.93-1.01	0.156
Male sex	1.23	0.48-3.15	0.665
Neoadjuvant therapy	0.78	0.29-2.08	0.619

Good continence defined as Wexner incontinence score ≤ 7 at 6 months. OR: Odds ratio; CI: Confidence interval; MSP: Maximum squeeze pressure.