Quality of life and functional outcome following anterior or abdominoperineal resection for rectal cancer

Guren, Marianne G.; Eriksen, Morten; Wiig, Johan N.; Carlsen, Erik; Nesbakken, Arild; Sigurðsson, Helgi; Wibe, Arne; Tveit, Kjell Magne

doi:10.1016/j.ejso.2005.05.004

Cited by 176 publications

(129 citation statements)

References 21 publications

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“…48 Among the studies included in this review, female response rates of less than 50% were common. 1,15,23,28 Identifying methods for improving response rates and defining sexual function and satisfaction is imperative for future study.…”

Section: Discussionmentioning

confidence: 99%

Sexual Function After Treatment for Rectal Cancer: A Review

Lee

Stein

et al. 2011

Diseases of the Colon &Amp; Rectum

134

101

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Sexual function is one element of QOL that may be significantly altered following treatment for rectal cancer, but the incidence and contributing risk factors are generally poorly understood. Nevertheless, the impact of rectal cancer therapy on sexual function should be conveyed to patients preoperatively. In addition to helping patients evolve realistic expectations, it will help clinicians identify those for whom interventions may be appropriate. In the past 10 years, there has been an increase in the number of studies reporting sexual dysfunction following rectal cancer treatment. However, these studies are difficult to interpret collectively for a variety of reasons. Most importantly, sexual dysfunction lacks a standardized definition, which leads to poor comparability between studies. The best inclusive definitions describe sexual dysfunction as a collection of distinct symptoms, which differ for men and women. The absence of sexual activity is sometimes used as a surrogate for sexual dysfunction, but this is confounded by an individual's desire and opportunity for sexual activity, and may not be an accurate reflection of physiologic functionality. Additional factors complicating assimilation of studies include the absence of baseline data, missing data, small sample sizes, and heterogeneity in use of validated and nonvalidated instruments. The purpose of this article is to systematically review the contemporary literature reporting sexual function after rectal surgery to determine the overall risk of sexual dysfunction, evaluate possible contributing factors, and identify questions that should be addressed in future studies.

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Section: Discussionmentioning

confidence: 99%

Sexual Function After Treatment for Rectal Cancer: A Review

Lee

Stein

et al. 2011

Diseases of the Colon &Amp; Rectum

134

101

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“…A report from Norway shows that, with a better body image and fewer male sexual problems, patients had a more favorable QOL after SPS compared with that after APR; however, there was no difference in overall QOL. 42 Even after total pelvic exenteration, even the patients with double stomas reported having a good QOL. This may be attributable to the adaptation or response shift seen particularly in individuals who have overcome cancer, a disease that threatens the patient's life.…”

Section: Defecation Function (Df)mentioning

confidence: 99%

Function preservation in rectal cancer surgery

Moriya

2006

Int J Clin Oncol

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When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the treatment of rectal cancer, surgeon-related factors are extremely important, not only in achieving local control but also in preserving function. This article reviews findings from recent studies investigating urinary, sexual, and defecation dysfunction after rectal cancer surgery and discusses questions to be studied in the future.

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“…The effect of pCRT may have potential detrimental effects on sphincter function, rectal capacity and bowel function [9,10]. Both the treatment-related side effects and bowel dysfunctions have been found to be associated with worse health-related quality of life (HRQOL) [9,[11][12][13][14][15][16][17][18], which is now considered a major outcome measure in surgical oncology [19]. Evaluating HRQOL outcomes of surgical interventions might be of great value as they inform about the disease burden and treatment-related effects directly from the patient's perspective.…”

Section: Introductionmentioning

confidence: 99%