title: Long-term functional and quality of life outcomes after coloanal anastomosis for distal rectal cancer.
abstract: OBJECTIVE
  This study was designed to evaluate the long-term functional and quality-of-life outcomes of patients after coloanal anastomosis for distal rectal cancer.
  
  
  METHODS
  A total of 192 patients underwent coloanal anastomosis between 1982 and 2001 at two tertiary referral institutions. Standardized and validated questionnaires to assess functional and quality-of-life outcomes were mailed to 151 patients, of which 121 patients responded (median follow-up, 65 months).
  
  
  RESULTS
  Patients receiving pelvic radiotherapy had more bowel function problems than patients who did not receive pelvic radiotherapy. No significant differences in relevant functional and quality-of-life outcomes were seen among patients who received preoperative or postoperative pelvic radiotherapy. Patients requiring permanent diversion as a result of complications of the surgery had decreased quality of life.
  
  
  CONCLUSIONS
  Coloanal anastomosis for distal rectal cancer has favorable long-term outcomes. Pelvic radiotherapy has an adverse effect on subsequent bowel function (whether given preoperatively or postoperatively) in patients who maintain intestinal continuity. Loss of intestinal continuity after a coloanal anastomosis is associated with diminished quality of life.
authors.affiliation: Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Imran
authors.initials: I
authors.lastname: Hassan
authors.forename: David W
authors.initials: DW
authors.lastname: Larson
authors.forename: Robert R
authors.initials: RR
authors.lastname: Cima
authors.forename: Janette U
authors.initials: JU
authors.lastname: Gaw
authors.forename: Heidi K
authors.initials: HK
authors.lastname: Chua
authors.forename: Dieter
authors.initials: D
authors.lastname: Hahnloser
authors.forename: John M
authors.initials: JM
authors.lastname: Stulak
authors.forename: Megan M
authors.initials: MM
authors.lastname: O'Byrne
authors.forename: Dirk R
authors.initials: DR
authors.lastname: Larson
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Wolff
authors.forename: John H
authors.initials: JH
authors.lastname: Pemberton
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery*; D003125:Colostomy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D011795:Surveys and Questionnaires