ArticleAnnals of surgery2024
Pelvic Floor Rehabilitation After Rectal Cancer Surgery One-year follow-up of a Multicenter Randomized Clinical Trial (FORCE trial).
Article in Annals of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Does robotic intersphincteric resection better preserve anal function in low rectal cancer: a systematic review and meta-analysis?Frontiers in medicine · 2026Pooled it
- Optimal interventions for low anterior resection syndrome: Bayesian network meta-analysis of randomized controlled trials.Techniques in coloproctology · 2025Pooled it
- Exploring Symptom Domains of Postoperative Bowel Dysfunction by Integrating LARS and Wexner Scores: A Longitudinal Factor-Analytic Study.Annals of gastroenterological surgery · 2026Article
- Structured pelvic floor physiotherapy rehabilitation for low anterior resection syndrome in colorectal cancer: An Australian feasibility study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Knowledge, Attitudes, and Practices Toward LARS Prevention in Rectal Cancer Patients With Prophylactic Stomas: A Multicenter Cross-Sectional Study.Nursing open · 2026Article
- Effectiveness of pelvic floor rehabilitation in the prevention and treatment of postoperative bowel symptoms in patients with rectal cancer: a systematic review and meta-analysis of randomized controlled trials.Journal of cancer survivorship : research and practice · 2026Review
- Laparoscopic Resection Rectopexy with Transanal Specimen Extraction for Complete Rectal Prolapse: Retrospective Cohort Study of Functional Outcomes.Journal of clinical medicine · 2026Article
- Distinct trajectories of low anterior resection syndrome following ileostomy reversal.Frontiers in medicine · 2026Article
- Low Anterior Resection Syndrome Evaluation and Management.Clinics in colon and rectal surgery · 2026Review
- Association between pre-reversal systemic inflammation response index and low anterior resection syndrome in rectal cancer patients: a retrospective cohort study.Frontiers in oncology · 2026Article
- The first Dutch experience with a nurse-led outpatient clinic for the prevention and treatment of LARS after colorectal surgery: promising results of a standardized treatment protocol.Techniques in coloproctology · 2025Observational
- Review
- Quality of Life in Rectal Cancer Treatments: An Updated Systematic Review of Randomized Controlled Trials (2013-2023).Cancers · 2025Review
- Article
- Long-term electroacupuncture for low anterior resection syndrome in postoperative rectal cancer patients: case reports.Frontiers in medicine · 2025Article
- Association Between Chemotherapy-Induced Peripheral Neuropathy and Low Anterior Resection Syndrome.Cancers · 2024Article
- Long-Term Functional Outcome After Early vs. Late Stoma Closure in Rectal Cancer Surgery: Sub-analysis of the Multicenter FORCE Trial.Journal of gastrointestinal cancer · 2024Article
- The impact of plasma-rich platelet injection to perianal sphincters on incontinence and quality of life in patients with rectal cancer after low anterior or intersphincteric resection: a prospective cohort study.Techniques in coloproctology · 2024Article
- Pelvic Floor Rehabilitation After Rectal Cancer Surgery One-year follow-up of a Multicenter Randomized Clinical Trial (FORCE trial).Annals of surgery · 2024Article
- Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aims to evaluate the effects of pelvic floor rehabilitation (PFR) after low anterior resection (LAR) at one-year follow-up. SUMMARY BACKGROUND DATA: After LAR, with restoration of bowel continuity, up to 90% of patients develop anorectal dysfunction, significantly impacting their quality of life. However, standardized treatment is currently unavailable. The FORCE trial demonstrated the beneficial effects of PFR after three months regarding specific domains of the Fecal Incontinence QoL (FIQL) questionnaire and urgency compared to usual care.
methodsThe FORCE trial is a multicenter, two-arm, randomized clinical trial. All patients undergoing LAR were randomly assigned to receive either usual care or a standardized PFR program. The primary outcome measure is the Wexner incontinence score, and the secondary endpoints included the LARS score, the EORTC colorectal-specific QoL questionnaire, and health- and fecal incontinence-related QoL. Assessments were conducted at baseline before randomization, at three months and one-year follow-ups.
resultsA total of 86 patients were included (PFR: n=40, control: n=46). After one year, PFR did not significantly improve Wexner incontinence scores (PFR: -3.33, 95% CI -4.41 to -2.26, control: -2.54, 95% CI -3.54 to -1.54, P=0.30). Similar to the three-month follow-up, patients without near-complete incontinence at baseline showed sustained improvement in fecal incontinence (PFR: -2.82, 95% CI -3.86 to -1.76, control: -1.43, 95% CI -2.36 to -0.50, P=0.06). Significant improvement was reported in the FIQL domains Lifestyle (PFR: 0.51, control: -0.13, P=0.03) and Coping and Behavior (PFR: 0.40, control: -0.24, P=0.01).
conclusionAt one-year follow-up, no significant differences were found in fecal incontinence scores; however, PFR was associated with improved fecal incontinence related QoL compared to usual care.
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Registered trials
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