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Int J Colorectal Dis. 2018 Aug;33(8):1039-1045. doi: 10.1007/s00384-018-3044-4. Epub 2018 Apr 19.

Late assessment of quality of life in patients with rectal carcinoma: comparison between sphincter preservation and definitive colostomy.

Author information

1
Department of Colorectal Tumors, AC Camargo Cancer Center, Professor Antonio Prudente, 211, Sao Paulo, SP, 01509-900, Brazil. mari_animo@hotmail.com.
2
Department of Colorectal Tumors, AC Camargo Cancer Center, Professor Antonio Prudente, 211, Sao Paulo, SP, 01509-900, Brazil.

Abstract

PURPOSE:

Patients with cancer of the lower and middle rectum who are candidates for curative surgery often have negative opinions on definitive colostomy. The purpose of this study is to compare the quality of life (QoL) of patients who undergo standard treatment for rectal cancer with sphincter preservation or definitive colostomy.

METHODS:

A total of 125 patients with adenocarcinoma of the lower or middle rectum who underwent radical surgery with curative intent with a follow-up ≥ 1 year were recruited: 83 patients (group 1) were subjected to low anterior resection and low colorectal or coloanal anastomosis-thus preserving their sphincter-and 42 (group 2) were treated with abdominoperineal resection, followed by terminal definitive colostomy. QoL was assessed with the EORTC QLQ-C30 and QLQ-CR29 questionnaires.

RESULTS:

Health and global quality of life were similar between groups; however, patients who underwent definitive colostomy had higher scores on the emotional (p value = 0.016) and cognitive function scales (p value = 0.017). Patients with sphincter preservation presented with more symptoms that were related to stool frequency (p value < 0.001), intestinal constipation (p value = 0.005), fecal incontinence (p value = 0.001), buttock pain (p value = 0.023), and nausea and vomiting (p value = 0.036), whereas patients with permanent colostomy had higher scores for dysuria (p value = 0.033).

CONCLUSION:

Although global QoL scores did not differ between groups, patients who underwent definitive colostomy had significantly better functional and symptom scale scores, reflecting greater function with fewer symptoms.

KEYWORDS:

Abdominoperineal resection; Colostomy; Low anterior resection; Quality of life; Rectal cancer

PMID:
29675592
PMCID:
PMC6060835
DOI:
10.1007/s00384-018-3044-4
[Indexed for MEDLINE]
Free PMC Article

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