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01.02.2007 | Ausgabe 2/2007

Diseases of the Colon & Rectum 2/2007

Prospective Evaluation of Quality of Life and Sexual Functioning After Laparoscopic Total Mesorectal Excision

Zeitschrift:
Diseases of the Colon & Rectum > Ausgabe 2/2007
Autoren:
M.D., PhD. S. O. Breukink, M.D., Ph.D. H. J. van der Zaag-Loonen, M.Sc. E. M. C. Bouma, M.D., Ph.D. J. P. E. N. Pierie, M.D. C. Hoff, M.D., Ph.D. T. Wiggers, M.D., Ph.D. W. J. H. J. Meijerink
Wichtige Hinweise
Presented at the meeting of the European Association for Endoscopic Surgery, Venice, Italy, June 1 to 4, 2005.
Presented at the meeting of the Society of American Gastrointestinal and Endoscopic Surgeons, Dallas, Texas, April 26 to 29, 2006.
Presented at the meeting of the 10th World Congress of Endoscopic Surgery, Berlin, Germany, September 13 to 19, 2006.

Purpose

This study was designed to investigate how the quality of life of patients with rectal cancer changes with time after laparoscopic total mesorectal excision.

Methods

Patients completed the Medical Outcomes Study Short Form 36 and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire and a colorectal-specific European Organisation for Research and Treatment of Cancer quality of life questionnaire before laparoscopic total mesorectal excision, on discharge from the hospital and at 3, 6, and 12 months postoperatively. Patients were treated by laparoscopic low anterior resection or laparoscopic abdominoperineal resection.

Results

Fifty-one patients (mean age, 64 years; 29 males (57 percent)) participated in this study, of whom 38 (75 percent) underwent laparoscopic low anterior resection and 13 (25 percent) laparoscopic abdominoperineal resection. Compared with preoperative scores on the Medical Outcomes Study Short Form 36, patients reported a deterioration in physical functioning (74 vs. 80; P = 0.009), and improved mental functioning (76 vs. 70; P = 0.007) at three months. Improvement in emotional well-being was reported both on the Medical Outcomes Study Short Form 36 (78 vs. 53; P = 0.006) and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (84 vs. 69; P < 0.001). At one year, improvements in global quality of life (82 vs. 68; P = 0.001) and symptoms, such as fatigue (18 vs. 32; P < 0.001), pain (5 vs. 12; P = 0.009), and appetite loss (3 vs. 13; P = 0.01), were reported. Sexual functioning was worse from three months onward until one year after surgery (47 vs. 66; P = 0.004). Patients who underwent low anterior resection experienced less sexual dysfunction than patients after abdominoperineal resection (21 vs. 56; P = 0.004).

Conclusions

One year after laparoscopic total mesorectal excision for rectal cancer, patients reported improvement in some important quality of life outcomes, including global quality of life, despite a decrease in sexual functioning.

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