Functional impairment and quality of life after rectal cancer surgery

Abstract

Background:The gold standard of rectal surgery remains total mesorrectal excision (ETM) in which laparoscopy is applied for its advantages. The attempt to avoid 17% conversion rate implies that transanal techniques are applied. Transanal ETM (TaETM) is performed by experimental groups with good oncological and morbimortality results. Objective: This study determines the quality of life and the anorectal function of these patients. Method: Observational study of two cohorts comparing patients undergoing rectal tumor surgery using TaETM or conventional ETM after a minimum of six months of intestinal transit reconstruction. EORTC-30, EORTC-29 quality of life questionnaires and the anorectal function assessment questionnaire (LARS score) are applied. General variables are also collected. Results: 31 patients between 2011 and 2014: 15 ETM group and 16 TaETM. We do not find statistically significant differences in quality of life questionnaires or in anorectal function. Statistically significant general variables: longer surgical time in the TaETM group. Nosocomial infection and minor suture failure in the TaETM group. Conclusion: The performance of TaETM achieves the same results in terms of quality of life and anorectal function as conventional ETM.

Functional complaints and quality of life after transanal total mesorectal excision: a meta-analysis

“…Scores on all other scales were comparable, including flatulence and sexual function. Mora et al . described more abdominal pain and a bloated feeling in the LapTME group.…”

“…Three studies compared TaTME with LapTME. Veltcamp Helbach and colleagues reported scores for role functioning (89·5 versus 80·2; P = 0·042), fatigue (12 versus 26·5; P = 0·021) and faecal incontinence (2·4 versus 14·8; P = 0·032) in favour of LapTME.…”

“…Mean temporary ileostomy rates were 92⋅2 per cent in the TaTME group compared with 88⋅1 per cent in the LapTME group. Some 61⋅5 per cent of the Mora et al 34 Veltcamp Helbach et al 30 Bjoern et al 29 Dou et al 47 Heterogeneity:…”

“…and †median (range). The International Prostate Symptom Score (IPSS) ranges from 0 to 35, with categories no/mild (0-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) complaints. IIEF, International Index of Erectile Function; TaTME, transanal total mesorectal excision; n.r., not reported/not reported correctly; LapTME, laparoscopic total mesorectal excision.…”

“…After 6 months, these effects disappeared, except for social functioning (P = 0⋅013) and anal pain (P = 0⋅013), which remained significantly worse than at baseline. Three studies 29,30,34 compared TaTME with LapTME. Veltcamp Helbach and colleagues 30 reported scores for role functioning (89⋅5 versus 80⋅2; P = 0⋅042), fatigue (12 versus 26⋅5; P = 0⋅021) and faecal incontinence (2⋅4 versus 14⋅8; P = 0⋅032) in favour of LapTME.…”