International Journal of Colorectal Disease, 2013, Vol.28(5), pp.679-688
Byline: Julia Konanz (1), Florian Herrle (1), Christel Weiss (2), Stefan Post (1), Peter Kienle (1) Keywords: Quality of life; Rectal cancer; Resection Abstract: Purpose Limits for sphincter preservation in rectal cancer have been expanded under the assumption that patients with a permanent colostomy have worse quality of life (QoL). Incontinence and painful defecation are common problems therefore, this study compares functional outcome and QoL after sphincter-sparing intersphincteric resection (ISR), low anterior resection (LAR), and abdominoperineal resection (APR) for rectal cancer. Methods From a prospective database, three matched groups of patients after surgery for rectal cancer between 1999 and 2009 were extracted. Median follow-up was 59 months. Of 131 patients receiving a questionnaire, 95 % could be analyzed further. Generic and disease-specific validated QoL (European Organization for Research and Treatment in Cancer QLQ-C30, CR38) and Wexner incontinence score were used. Results Global QoL was comparable between the groups. Physical functioning was significantly better after sphincter preservation surgery than APR (p〈0.05). Symptom scores for diarrhea (DIA) and constipation (CON) were higher after sphincter-preserving surgery (ISR: DIA 45.4, CON 20.2 LAR: DIA 34.1, CON 25.2) compared to APR (DIA 16.6, CON 12.0) (p〈0.05 and 〈0.01, respectively). Disease-specific QoL assessment showed significantly worse QoL regarding to male sexual function after APR (80.8) than after ISR (53.6) (p〈0.005). Regarding defecation, the ISR group showed significantly higher symptom scores than patients after LAR (p〈0.05). Wexner scores were significantly higher after ISR (12.9) than after LAR (9.5) (p〈0.005). Author Affiliation: (1) Department of Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim of the University of Heidelberg, 68167, Mannheim, Germany (2) Institute of Medical Statistics and Biometry, University Medical Centre Mannheim, Medical Faculty Mannheim of the University of Heidelberg, 68167, Mannheim, Germany Article History: Registration Date: 18/03/2013 Accepted Date: 18/03/2013 Online Date: 10/04/2013 Article note: Julia Konanz and Florian Herrle are equal first author.
Quality of life ; Rectal cancer ; Resection
View full text in Springer (Subscribers only)