Quality of life after anterior resection versus abdominoperineal extirpation for rectal cancer.
BACKGROUND
Abdominoperineal extirpation has been assumed to put patients at higher risk of disruption to quality of life than sphincter-preserving surgery in rectal cancer surgery. The aim of this study was to investigate quality of life in patients after anterior resection versus abdominoperineal extirpation for rectal cancer and to evaluate the psychometrics of the Danish version of a symptom-specific Fecal Incontinence Quality of Life Scale.


METHODS
Fourteen patients undergoing abdominoperineal extirpation and 26 undergoing anterior resection. The generic quality of life instrument SF-36 together with a new symptom-specific Fecal Incontinence Quality of Life Scale were used. Psychometric analysis of the symptom-specific scale was carried out.


RESULTS
The only significant difference between the two groups was found in the total score of the symptom-specific scale in favour of anterior resection (P = 0.02). Psychometric evaluation of the symptom-specific fecal incontinence questionnaire proved it reliable and valid.


CONCLUSIONS
The present study shows that a stoma influences quality of life only slightly, while a relatively high anterior resection does not. However, a few appropriate newer studies indicate that the cost of spinchter-preserving techniques in the form of incontinence disturbances may influence the quality of life seriously, which should be borne in mind when low anterior resection is intended. Further studies in this field are necessary and could benefit from use of the Fecal Incontinence Quality of Life Scale, including its total score.
Jess
P
P
Dept. of Surgical Gastroenterology, Herlev University Hospital, Denmark. per.jess@dadlnet.dk
Christiansen
J
J
Bech
P
P
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D003718:Denmark; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005242:Fecal Incontinence / Q000209:etiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery*; D011183:Postoperative Complications; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012004:Rectal Neoplasms / Q000150:complications* / Q000523:psychology / Q000601:surgery*; D015203:Reproducibility of Results