Quality of Life Following Rectal Cancer Resection: Pros and Cons of Sphincter Preservation

ABSTRACT

It is evident that surgery for rectal cancer has an important impact on a patient's quality of life.

In recent years, due to a change in philosophy regarding the distal margin plus the introduction of circular stapling devices, a sphincter-sparing resection has become feasible in most patients with rectal cancer.

As shown in numerous studies, ultralow anterior resections or intersphincteric resections with a coloanal anastomosis for rectal cancer do not compromise oncologic results compared with an abdominoperineal resection. Recently, with an increasing number of sphincter-saving procedures, reduced mortality and operative morbidity, and local recurrence rates, a change in assessing outcome has become apparent. While overall survival and local recurrence rates remain the primary concern, both patients and surgeons are interested in long-term functional results and quality of life. A vast body of literature suggests that patients who have a colostomy have a worse quality of life than those without a stoma; however, few studies measured global quality of life prospectively, using a well-researched questionnaire.

The aim of this article is to discuss the available literature and our own results regarding quality of life following sphincter-sparing surgery and abdominoperineal excision for rectal cancer.

KEYWORD

Rectal cancer - sphincter preservation - quality of life

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