Health‐related quality of life in patients with lower rectal cancer after sphincter‐saving surgery: a prospective 6‐month follow‐up study

• Published in: European journal of cancer care Vol. 26; no. 4; pp. e12417 - n/a
• Main Authors: Kinoshita, Y., Nokes, K.M., Kawamoto, R., Kanaoka, M., Miyazono, M., Nakao, H., Chishaki, A., Mibu, R.
• Format: Journal Article
• Language: English
• Published: England Hindawi Limited 01.07.2017
• Subjects: Activities of Daily Living; Anal Canal - surgery; Analysis of Variance; Cancer; Colorectal cancer; Defecation; Defecation - physiology; defecation symptoms; Female; Follow-Up Studies; Health Status; health‐related quality of life; Humans; intersphincteric resection; Male; Middle Aged; Nursing; Organ Sparing Treatments - methods; Patients; Postoperative Complications - etiology; Postoperative Complications - physiopathology; Prospective Studies; Quality of Life; rectal neoplasms; Rectal Neoplasms - physiopathology; Rectal Neoplasms - surgery; Rectum; Self Care; Social interactions; Social Support; Sphincter; sphincter‐saving surgery; Surgery; rectal neoplasms; health-related quality of life; sphincter-saving surgery; defecation symptoms; intersphincteric resection; prospective studies
• ISSN: 0961-5423; 1365-2354
• DOI: 10.1111/ecc.12417

This longitudinal descriptive study examined whether rectal cancer patients report changes in health‐related quality of life (HRQOL) over a 6‐month period after different types of sphincter‐saving surgery (SSS): intersphincteric resection (ISR), ultra‐low anterior resection (ULAR) and low anterior resection (LAR). It also compares HRQOL among the three groups of patients. Seventy‐three patients from two hospitals in Japan completed questionnaires on HRQOL and defecation symptoms immediately before surgery and 1 and 6 months afterwards. Results showed that ISR patients had significantly worse HRQOL scores than ULAR and LAR patients and more defecation symptoms that persisted during the 6 months post‐SSS. Thus, patients undergoing ISR require psychological and social support, including skills in competent self‐management, during the early post‐operative period. Furthermore, defecation problems substantially influence HRQOL. The first month post‐SSS is particularly challenging. The assumption that HRQOL is better after SSS compared to living with a permanent stoma might not be valid.