The impact of restorative proctectomy versus permanent colostomy on health-related quality of life after rectal cancer surgery using the patient-generated index

Robitaille, Stephan; Maalouf, Michael F; Penta, Ruxandra; Joshua, Temitope Grace; Liberman, Alexander; Fiore, Julio F.; Feldman, Liane S.; Lee, L.

doi:10.1016/j.surg.2023.06.033

Cited by 6 publications

(2 citation statements)

References 31 publications

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“…Among respondents, those with ostomies tended to have lower scores overall, indicative of worse overall QOL, although results were not statistically significant ( p = 0.12), possibly indicative of a limited sample size to detect differences across groups. Studies evaluating QOL after ostomy for patients with colorectal cancer found that living with a permanent ostomy impacts QOL negatively due to sexual problems, depressive feelings, gas, constipation, dissatisfaction with appearance, change in clothing, travel difficulties, feeling tired, and worry about noises [ 34 , 35 , 36 , 37 ]. Alternatively, our results may support published studies which suggest that the presence of a permanent ostomy does not have an adverse impact on overall QOL [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Patient-Reported Sexual Function, Bladder Function and Quality of Life for Patients with Low Rectal Cancers with or without a Permanent Ostomy

Rooney,

Pasli,

Chang

et al. 2023

Cancers

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Background: Despite the increasing utilization of sphincter and/or organ-preservation treatment strategies, many patients with low-lying rectal cancers require abdominoperineal resection (APR), leading to permanent ostomy. Here, we aimed to characterize overall, sexual-, and bladder-related patient-reported quality of life (QOL) for individuals with low rectal cancers. We additionally aimed to explore potential differences in patient-reported outcomes between patients with and without a permanent ostomy. Methods: We distributed a comprehensive survey consisting of various patient-reported outcome measures, including the FACT-G7 survey, ICIQ MLUTS/FLUTS, IIEF-5/FSFI, and a specific questionnaire for ostomy patients. Descriptive statistics and univariate comparisons were used to compared demographics, treatments, and QOL scores between patients with and without a permanent ostomy. Results: Of the 204 patients contacted, 124 (60.8%) returned completed surveys; 22 (18%) of these had a permanent ostomy at the time of survey completion. There were 25 patients with low rectal tumors (≤5 cm from the anal verge) who did not have an ostomy at the time of survey completion, of whom 13 (52%) were managed with a non-operative approach. FACTG7 scores were numerically lower (median 20.5 vs. 22, p = 0.12) for individuals with an ostomy. Sexual function measures IIEF and FSFI were also lower (worse) for individuals with ostomies, but the results were not significantly different. MLUTS and FLUTS scores were both higher in individuals with ostomies (median 11 vs. 5, p = 0.06 and median 17 vs. 5.5, p = 0.01, respectively), suggesting worse urinary function. Patient-reported ostomy-specific challenges included gastrointestinal concerns (e.g., gas, odor, diarrhea) that may affect social activities and personal relationships. Conclusions: Despite a limited sample size, this study provides patient-centered, patient-derived data regarding long-term QOL in validated measures following treatment of low rectal cancers. Ostomies may have multidimensional negative impacts on QOL, and these findings warrant continued investigation in a prospective setting. These results may be used to inform shared decision making for individuals with low rectal cancers in both the settings of organ preservation and permanent ostomy.

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Section: Discussionmentioning

confidence: 99%

Patient-Reported Sexual Function, Bladder Function and Quality of Life for Patients with Low Rectal Cancers with or without a Permanent Ostomy

Rooney,

Pasli,

Chang

et al. 2023

Cancers

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“…Furthermore, approximately 20-25% of patients operated with a primary anastomosis ended up with a stoma because of anastomotic leakage or unsatisfactory anorectal function [2] . Although surgery could improve the survival rate of patients with rectal cancer, colostomy changed the original method of defecation and could not control defecation at will, which could inevitably cause problems and affect their quality of life [3] . Most patients undergoing colostomy were excessively dependent on medical staff, did not know much about colostomy care and complication prevention, and were coupled with maladjustment to colostomy.…”

Section: Introductionmentioning

confidence: 99%

The safety and effectiveness of telemedicine for cancer-related colostomy care in early stage of discharge: A prospective, randomized, single-center study

Quan,

Wang,

Yang

et al. 2024

Preprint

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Background There has been an exponential growth in the use of telemedicine services to provide clinical care. However, the safety and effectiveness of telemedicine in cancer-related colostomy care during the early stages of discharge remains unclear. This study aimed to prove that the safety and effectiveness of telemedicine for cancer-related colostomy care are not inferior to those of outpatient care. Methods This was a prospective, randomized, noninferiority study. A total of 76 consecutive patients who underwent cancer-related colostomy stoma were enrolled and randomly divided into a telemedicine group or an outpatient group with an equal allocation ratio (1:1). The outpatient group was provided in-person interview mode colostomy care, whereas the telemedicine group was provided video interview mode colostomy care. Using stoma-related complications, self-care ability and quality of life reflected the safety and effectiveness of colostomy care in the early stages of discharge. Results The incidence of stoma-related complications within 2-weeks and 1-month after discharge showed no significant differences between the two groups (P2 − weeks = 0.772 and P1 − month = 0.760). The NCI-CTCAE score for stoma-related complications was less than level 2. Patients with complications need not be hospitalized. The ESCA scores were 101.4 ± 13.9 and 106.3 ± 16.5, respectively, in the telemedicine group, and 101.8 ± 13.5 and 103.3 ± 13.4, respectively, in the outpatient group. The C-COH-QOL-OQ scores were 6.15 ± 0.91 and 6.34 ± 0.86, respectively, in the telemedicine group, and 6.27 ± 0.71 and 6.38 ± 0.61, respectively, in the outpatient group. The ESCA and C-COH-QOL-OQ scores were not significantly different between the telemedicine and outpatient group in 2-weeks and 1-month after discharge (all P > 0.05). Conclusion The results of this study revealed that the safety and effectiveness of telemedicine for cancer-related colostomy in the early stages of discharge were not inferior to those of outpatient care. When using telemedicine for cancer-related colostomy care, communication between the medical staff and patients is broken through the restrictions of time and place.

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Decision-making preferences and regret in rectal cancer patients undergoing restorative proctectomy: A prospective cohort study

Joshua,

Robitaille,

Paradis

et al. 2024

Surgery

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The impact of restorative proctectomy versus permanent colostomy on health-related quality of life after rectal cancer surgery using the patient-generated index

Cited by 6 publications

References 31 publications

Patient-Reported Sexual Function, Bladder Function and Quality of Life for Patients with Low Rectal Cancers with or without a Permanent Ostomy

Patient-Reported Sexual Function, Bladder Function and Quality of Life for Patients with Low Rectal Cancers with or without a Permanent Ostomy

The safety and effectiveness of telemedicine for cancer-related colostomy care in early stage of discharge: A prospective, randomized, single-center study

Decision-making preferences and regret in rectal cancer patients undergoing restorative proctectomy: A prospective cohort study

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