The impact of surgical modality on self-reported body image, quality of life and survivorship after anterior resection for colorectal cancer – a mixed methods study

Abstract

Background: There is growing enthusiasm for robotic and transanal surgery as an alternative to open or laparoscopic surgery for colorectal cancer (CRC). We examined the impact of surgical modality on body image and quality of life (QOL) in patients receiving anterior resection for CRC. Methods: We used a mixed-methods approach, consisting of a chart review and semistructured interviews with CRC patients, at least 8 months after surgery. We assessed cosmetic outcomes and QOL using validated questionnaires. Results: Thirty patients were stratified into open (n = 8), laparoscopic (n = 12) and robotic (n = 10) groups. Mean body image scores were significantly higher (i.e., poorer body image) in patients receiving open surgery (mean difference [MD] +5.7 with laparoscopy, p < 0.001). Open surgery was more detrimental to physical function, including strenuous activities, prolonged ambulation and self-care (MD-11.6 with laparoscopy, p = 0.039). Patients receiving laparoscopic surgery reported superior role (MD +27.6 with open surgery, p = 0.002) and social function (MD +13.7 with open surgery, p = 0.042), including the ability to enjoy hobbies, family life and social activities. Surgical modality did not affect emotional and cognitive function or symptoms including genitourinary function, pain and defecation. Conclusion: The negative impact of open surgery on body image and physical function warrants further educational interventions for patients. The protective effect of laparoscopy on role and function may be associated with "tumour factors" that are unaccounted for in the European Organization for Research and Treatment of Cancer questionnaires. Open surgery is detrimental to body image and physical function in patients receiving anterior resection for CRC. Prospective randomized studies are required to validate these findings. Contexte : On observe un intérêt croissant pour la chirurgie transanale robotique comme solution de rechange à la chirurgie ouverte ou laparoscopique dans les cas de cancer colorectal (CCR). Nous avons analysé l'impact de la modalité chirurgicale sur l'image corporelle et la qualité de vie (QdV) chez les patients ayant subi une résection antérieure pour CCR. Méthodes : Nous avons utilisé une approche à méthodologie mixte, composée d'une revue des dossiers et d'entrevues semi-structurées avec des patients atteints de CCR, au moins 8 mois après la chirurgie. Nous avons évalué les résultats cosmétiques et la QdV au moyen de questionnaires validés. Résultats : Trente patients ont été stratifiés en 3 groupes : chirurgie ouverte (n = 8), laparoscopique (n = 12) et robotique (n = 10). Les scores moyens pour l'image corporelle ont été significativement plus élevés (c.-à-d., image corporelle plus négative) chez les patients ayant subi une chirurgie ouverte (différence moyenne [DM] +5,7 avec la laparoscopie, p < 0,001). La chirurgie ouverte a été plus nuisible au fonctionnement physique, y compris aux activités exigeantes, à la déambulation prolongée et à l'autosoin (DM-11,6 avec la laparoscopie, p = 0,0...

Adaptive Response of Colorectal Cancer Patients With Stomas on Quality of Life and Body Images: A Literature Review

“…To optimize this interpretation, we will first clarify the research findings from a review of 11 articles. For adaptation Other patients can use their adaptation process to respond positively [5], an adaptation process that requires a long time [6], patients adapt positively to a stoma attached condition [5] There is an increase in stoma acceptance [7].…”

“…The results of interpreting body image from existing articles are as follows, there is a change in body image [8], the use of a stoma or ileostomy is difficult for some people [5], there is a decrease in physical and self-image , the stoma has a negative impact on the body image [7]. There is an increase in stoma acceptance [9].…”

“…The most significant changes occurred in dietary patterns, clothing, social behaviour [10], The use of a stoma or ileostomy is difficult for some people. Intimate relationships and friends are often disrupted by the presence of a stoma [11], there are three categories that appear that are very dangerous or affect the quality of life [12] there are obstacles to weak physical decline against cancer as you get older [6], there is an impact of surgical morality on decreasing quality of life in patients [7].…”

“…The results of interpreting body image from existing articles are as follows, there is a change in body image [10], the use of a stoma or ileostomy is difficult for some people [5], there is a decrease in physical and self-image [14], the stoma has a negative impact on the body image [7] this is because the stoma is considered very disgusting. There is a change in the place of defecation, which is usually in the anus, now moving in the stomach and having to always change the bag really makes a decrease in body image [7]…”

Single‐port robot‐assisted radical prostatectomy: a systematic review and pooled analysis of the preliminary experiences

“…Furthermore, in order to preserve patient’s body image and improve cosmesis, there has been a constant drive to achieve reductions in the invasiveness of surgery, which has evolved from open to laparoscopic surgery, then to robotic multiport surgery, and finally to SP surgery, with its improved impact on patients' self‐esteem [33,34].…”