Long-term functional and quality of life outcomes after coloanal anastomosis for distal rectal cancer.
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.
Hassan
Imran
I
Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Larson
David W
DW
Cima
Robert R
RR
Gaw
Janette U
JU
Chua
Heidi K
HK
Hahnloser
Dieter
D
Stulak
John M
JM
O'Byrne
Megan M
MM
Larson
Dirk R
DR
Wolff
Bruce G
BG
Pemberton
John H
JH
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