title: Patients' preferences for low rectal cancer surgery.
abstract: OBJECTIVE
  To elicit surgery preferences of patients who have experience with either low anterior resection (LAR) or abdominoperineal resection (APR) and its outcomes, to support decision-making in future patients with resectable rectal cancer.
  
  
  METHODS
  One hundred and twenty-two patients were interviewed. Surgery preference was assessed in two ways. In the treatment trade-off method, the certainty of a stoma was hypothetically weighed against the risk of incontinence. In the time trade-off method, remaining life expectancy was traded off to avoid a permanent stoma or faecal incontinence.
  
  
  RESULTS
  To avoid APR, LAR patients accepted a much higher risk of incontinence than APR patients. In fact, 71% of the LAR patients chose LAR if they would certainly suffer monthly incontinence, and still 32% if they would certainly suffer daily incontinence. Nevertheless, APR patients would give up less remaining life years to be without a permanent stoma than LAR patients to be without monthly incontinence.
  
  
  CONCLUSIONS
  Most patients preferred LAR above APR, even if LAR involved a risk of faecal incontinence. This seems to justify that LAR, if surgically possible, is performed in the first instance. However, since APR patients could live well with a permanent stoma, we recommend clearly informing patients before surgery about the surgical options and their potential outcomes.
authors: Department of Clinical Oncology, Leiden University Medical Center, The Netherlands.
authors: E
authors: E
authors: Bossema
authors: A
authors: A
authors: Stiggelbout
authors: M
authors: M
authors: Baas-Thijssen
authors: C
authors: C
authors: van de Velde
authors: C
authors: C
authors: Marijnen
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D012004:Rectal Neoplasms / Q000601:surgery*; D012307:Risk Factors; D013997:Time Factors; D014549:Urinary Incontinence