BACKGROUND: After total mesorectal excision for rectal cancer, many surgeons try to avoid an abdominoperineal resection (APR) by performing a transanally double stapled low colo-rectal anastomosis (LRA), frequently without a pouch. This policy is mainly based on the assumption that the quality of life after such LRA is higher than after APR. It has been suggested that a better functional outcome and therefore a higher quality of life might be achieved by a colo-anal J-pouch anastomosis (CPA). The aim of this study was to assess quality of life among disease-free survivors after APR, LRA and CPA. METHODS: The charts of 301 consecutive patients who had undergone surgery for cancer in the middle or lower third of the rectum were analysed. Two hundred four patients were eligible for inclusion. The quality of life among these patients was assessed using one generic (EQ-5D) and two disease-specific questionnaires (EORTC QLQ-C30 and EORTC QLQ-CR38). RESULTS: The response rate was 82%. The median follow-up was 31 months. Overall, quality of life was good but CPA patients had better quality of life scores than APR and LRA patients. This difference was not only due to the better functional outcome but also to the lower incidence of disturbed micturition and sexual problems in the CPA group. CONCLUSION: The quality of life after colo-anal J-pouch anastomosis is better than after abdominoperineal resection (APR) and low colo-rectal anastomosis (LRA). The quality of life after APR is similar to that after LRA.
BACKGROUND: After total mesorectal excision for rectal cancer, many surgeons try to avoid an abdominoperineal resection (APR) by performing a transanally double stapled low colo-rectal anastomosis (LRA), frequently without a pouch. This policy is mainly based on the assumption that the quality of life after such LRA is higher than after APR. It has been suggested that a better functional outcome and therefore a higher quality of life might be achieved by a colo-anal J-pouch anastomosis (CPA). The aim of this study was to assess quality of life among disease-free survivors after APR, LRA and CPA. METHODS: The charts of 301 consecutive patients who had undergone surgery for cancer in the middle or lower third of the rectum were analysed. Two hundred four patients were eligible for inclusion. The quality of life among these patients was assessed using one generic (EQ-5D) and two disease-specific questionnaires (EORTC QLQ-C30 and EORTC QLQ-CR38). RESULTS: The response rate was 82%. The median follow-up was 31 months. Overall, quality of life was good but CPApatients had better quality of life scores than APR and LRApatients. This difference was not only due to the better functional outcome but also to the lower incidence of disturbed micturition and sexual problems in the CPA group. CONCLUSION: The quality of life after colo-anal J-pouch anastomosis is better than after abdominoperineal resection (APR) and low colo-rectal anastomosis (LRA). The quality of life after APR is similar to that after LRA.
Authors: P G Vaughan-Shaw; A T King; T Cheung; N E Beck; J S Knight; P H Nichols; K P Nugent; S A Pilkington; J A Smallwood; A H Mirnezami Journal: Ann R Coll Surg Engl Date: 2011-09 Impact factor: 1.891
Authors: Rosa Digennaro; Mirna Tondo; Filippa Cuccia; Ivana Giannini; Francesco Pezzolla; Marcella Rinaldi; Dario Scala; Giovanni Romano; Donato F Altomare Journal: Int J Colorectal Dis Date: 2012-12-30 Impact factor: 2.571
Authors: Robert N Whistance; Rebecca Gilbert; Peter Fayers; Robert J Longman; Anne Pullyblank; Michael Thomas; Jane M Blazeby Journal: Int J Colorectal Dis Date: 2009-12-02 Impact factor: 2.571
Authors: Letácio José Freire Santos; João Batista dos Santos Garcia; Jairo Sousa Pacheco; Erica Brandão de Morais Vieira; Alcione Miranda dos Santos Journal: Arq Bras Cir Dig Date: 2014 Apr-Jun