Comparison of Quality of Life Scores in Patients Who Underwent Low Anterior Resection and Abdominoperineal Resection for Tumors of The Rectum

Abstract

Objectives: This study makes a comparison of the quality of life of patients who have undergone different forms of radical surgery for tumors of the rectum. Background: Colorectal carcinoma is the third most common form of cancer among all cancer types, and the most common type of all gastrointestinal system cancers.Methods: Patients who had undergone a Low Anterior Resection (LAR) or an Abdominoperineal Resection (APR) for rectal cancer were compared using the Short Form-36 (SF-36) quality of life measure. Results:The physical function, role limitations due to physical functions, role limitations due to emotional problems, vitality, mental health, social functionality, and general health perception of the patients who underwent APR were statistically and significantly better then in patients who underwent LAR, while no significant difference was found in the bodily pain scores of the two groups. Conclusion:Patients who underwent LAR achieve a quite good quality of life when no complications developed, while their quality of life was poorer than those fitted with a permanent stoma upon the development of complications. In this regard, the APR resection technique may be preferable to restorative procedures when there is a high risk of such complications as anastomotic stricture and anastomotic leakage.

Discussion of QOL (with Concise Summary of Newer Clinical Research) in Colorectal Cancer Patients Treated in a Retrospective Trial on the Effect of Surgical Resection Margins on Survival, with Relation to Operation Type

“…Because of the aforementioned, the continuation of the intestinal passage is, in clinical practice, desired in nearly every case (25). Despite the bene ts offered by the LAR, low anterior resection syndrome (LARS) is a major problem for long term QOL.…”

“…Thus, smaller DRM, could help the surgeon operate di cult cases, with proper oncological principles, resulting in more favorable long-term survival and functional prognosis. Though caution should still be exercised and so surgeons should not attempt a preferred surgery at any price, but should instead seek to individualize treatment for every case -as well as evaluate for complications both pre and intraoperatively (25). This knowledge could potentially be used to counsel the patient, when conditions for operation, are less than ideal (even when an APR is potentially required).…”

“…This knowledge could potentially be used to counsel the patient, when conditions for operation, are less than ideal (even when an APR is potentially required). Though, it may be prudent, to view APR as more than a last line treatment in older patients, patients with low life expectancy or major anorectal dysfunction (25).…”