06.06.2025 | Originalien
Comparison of quality of life between intersphincteric and abdominoperineal resection in patients with low rectal cancer
verfasst von: Adnan Abdulkadir Mohammed, Sara Shojaei-Zarghani, Zahra Ghanbarzadegan, Zahra Zabangirfard, Ahmed Mohammed Ali Hussein Alhurry, Dr. Khadije Gorgi, MD, Seyed Vahid Hosseini
Erschienen in: coloproctology
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Background
Low rectal cancer presents significant challenges to surgical management, especially when selecting a procedure that balances oncological effectiveness with quality of life (QoL) considerations. Intersphincteric resection (ISR) has emerged as a sphincter-preserving alternative to traditional abdominoperineal resection (APR). However, there is a lack of comparative studies focusing on the long-term postoperative QoL of these two approaches. This study aims to fill this knowledge gap by evaluating QoL after ISR versus APR.
Methods
This study utilized data from the Shiraz Colorectal Cancer Surgery (SCORCS) registry at Shiraz University of Medical Sciences. The registry tracks patients with pathologically confirmed colon or rectal cancer who underwent surgery at three different hospitals. Patients eligible for the ISR group had to be alive, not have a temporary stoma, and have had a tumor located within 6 cm of the anal verge. A matched group of patients who underwent APR were selected based on age, sex, time since surgery, and tumor stage. The QoL assessments were conducted using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR29 questionnaires. The significance level was set at p < 0.05.
Results
Among the 32 patients undergoing ISR, 22 were included in the final analysis. A matched group of 48 patients undergoing APR was formed, with 32 ultimately analyzed. The median age of participants was 61 years at questionnaire completion, with a median follow-up of 41.5 months. While QoL indicators from EORTC QLQ-C30 showed no significant differences between the ISR and APR groups, ISR patients reported significantly higher sexual interest, higher stool frequency, and lower urinary incontinence according to EORTC QLQ-CR29.
Conclusion
Patients undergoing ISR reported significantly higher sexual interest, higher stool frequency, and lower urinary incontinence compared to patients with APR. These findings suggest that while both surgical techniques are comparable overall, ISR offers specific advantages in critical functional areas.
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