1. Antegrade enema after TME for rectal cancer: the last chance to avoid definitive colostomy for refractory LARS and fecal incontinence.

2. Anterograde enema
15 studies
374 patients
Full continence: 33% to 100%

3. Objective To assess functional results and Qol of patients
after antegrade colonic enema
for refractory LARS and fecal incontinence after TME

4. Endpoints Primary endpoint Secondaries endpoints Wexner score
LARS and GIQLI score
Mobidity (Dindo score)
Rate of definitive stoma

5. POPULATION n (%) Age (years) 62 Gender Male 19 (76) Female 6 (24)
Surgery
Low anterior resection
Colo anal anastomosis 18
(72)
Colo perineal anastomosis after APR 1
(4)
Preoperative radio-chemotherapy 22
(88)

6. Wexner score

7. lars score

8. Giqli score

9. Antegrade enema for major and refractory LARS and
Conclusion
Antegrade enema for major and refractory LARS and
fecal incontinence after TME appears to be a promising treatment to avoid definitive colostomy