title: Quality of life after low anterior resection and temporary loop ileostomy.
abstract: OBJECTIVE
  Low anterior resection has become the operation of choice for mid rectal or low rectal cancer. A defunctioning stoma is routinely created at some centers to decrease the risk of leakage requiring surgical intervention. This study was designed to evaluate the quality of life in patients undergoing low anterior resection with a temporary ileostomy.
  
  
  METHODS
  A prospective longitudinal study was conducted in 22 patients with rectal cancer who underwent low anterior resection with a loop ileostomy. Quality of life was assessed by using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR38 questionnaires. Twenty-five patients who underwent high anterior resection for rectosigmoid cancer were studied concurrently to evaluate the impact of major colorectal resection without a stoma.
  
  
  RESULTS
  Patients' scores on the quality of life questionnaires generally improved after high anterior resection; however, for patients who underwent low anterior resection, the scores for physical and role functioning before ileostomy closure were worse than the preoperative values. The scores on the quality of life questionnaires generally improved after ileostomy closure. Ileostomy closure required a short hospital stay and was rarely associated with complications.
  
  
  CONCLUSIONS
  Patients who underwent low anterior resection with ileostomy had significant reductions in physical and role functioning, which apparently improved after ileostomy closure. Similar declines in these quality of life variables were not found in patients who underwent high anterior resection. A temporary ileostomy should be created in selected patients with the highest risk of anastomotic leakage. Increased resources for not only surgical care but also for stoma therapy are necessary for patients who undergo low anterior resection with a temporary ileostomy.
authors.affiliation: Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan. at1151proc@med.showa-u.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Tsunoda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tsunoda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Narita
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakao
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Kusano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000523:psychology / Q000601:surgery*; D012811:Sigmoid Neoplasms / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome