Systematic review: the effect of right hemicolectomy for cancer on postoperative bowel function
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REVIEW ARTICLE
Systematic review: the effect of right hemicolectomy for cancer on postoperative bowel function C. Hope 1
&
J. Reilly 2 & J. Lund 1 & HJN Andreyev 3,4
Received: 23 December 2019 / Accepted: 6 May 2020 # The Author(s) 2020
Abstract Background Right-sided cancer accounts for approximately 30% of bowel cancer in women and 22% in men. Colonic resection can cause changes in bowel function which affect daily activity. The aims are to assess the impact of right hemicolectomy for cancer on bowel function and to identify useful treatment modalities for managing bowel dysfunction after right hemicolectomy. Method The review was conducted in line with PRISMA. Eligible studies evaluated the impact of right hemicolectomy on bowel function in those treated for colorectal neoplasia or assessed the effect of surgical technique or other intervention on bowel function after right hemicolectomy. Right hemicolectomy for inflammatory bowel disease or benign cases only were excluded. Articles were limited to studies on human subjects written in English published between January 2008 and December 2018. Results The searches identified 7531 articles. Nine articles met the inclusion criteria, of which eight were cohort studies and one was a randomised trial. Loose stool, increased bowel frequency and/or nocturnal defaecation following right-sided colectomy occurs in approximately one in five patients. Some of these symptoms may improve spontaneously with time. Bile acid malabsorption and/or small bowel bacterial overgrowth may be the cause for chronic dysfunction. Some studies report that no or little difference in outcome between right-sided and rectal resections likely suggests poor function after right-sided resection. Conclusion Right hemicolectomy can result in changes to bowel function. Patients should be counselled preoperatively, and follow-up should be designed to identify and effectively treat significantly altered bowel function. Keywords Colorectal cancer . Colorectal surgery . Bowel function . Right hemicolectomy . Gastrointestinal surgery . Adenocarcinoma
Introduction Right-sided colon cancer accounts for approximately 30% of bowel cancer in women and 22% in men [1]. Earlier detection by screening programmes and advances in adjuvant treatments, combined with improved patient selection, means that the proportion of people surviving bowel cancer in the UK has * C. Hope [email protected] 1
Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby DE22 3DT, UK
2
Department of Hepatobiliary Surgery, Queens Medical Centre, Nottingham NG7 2UH, UK
3
Department of Gastroenterology, Lincoln County Hospital, Greetwell Road, Lincoln LN2 5QY, UK
4
School of Medicine, University of Nottingham, Nottingham, UK
more than doubled in the last 40 years [2]. Curative treatment for right-sided colonic cancer includes right hemicolectomy with or without adjuvant chemotherapy. Colonic resection can cause changes in bowel function whi
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