Quality of life after transperineal rectosigmoidectomy.
BACKGROUND
: This study evaluated continence, constipation and quality of life before and after perineal rectosigmoidectomy for full-thickness rectal prolapse.


METHODS
: Consecutive patients with full-thickness rectal prolapse undergoing perineal rectosigmoid- ectomy (Altemeier's procedure) between May 2004 and June 2008 were studied. A standardized questionnaire, including the Cleveland Clinic Constipation Score (CCCS), Cleveland Clinic Incontinence Score (CCIS) and quality of life scores (EuroQol-Five Dimensions, EuroQol-Visual Analogue Scale and Patient Assessment of Constipation-Quality of Life (PAC-QOL)), was administered before and after operation.


RESULTS
: Thirty-eight patients (32 women) of mean(s.d.) age 75(13) years underwent rectosigmoid- ectomy. Seven patients developed postoperative complications and one died. There was one recurrence 5 months after surgery. Twenty-nine patients completed the follow-up questionnaire and were reviewed after a median of 24 (range 6-48) months. Constipation and incontinence were significantly improved after surgery (mean CCCS from 10.21 to 3.58 and CCIS from 14.17 to 11.42; P < 0.001). Quality of life, in terms of mobility, usual activities, pain/discomfort and anxiety/depression, were significantly better at follow-up (P < 0.001), as was subjective health status (P < 0.001). The PAC-QOL score improved significantly in all dimensions (P < 0.001).


CONCLUSIONS
: Transperineal rectosigmoidectomy improves general and constipation-related quality of life with good functional results.
Kim
M
M
Department of General, Gastrointestinal, Vascular and Paediatric Surgery, University Hospital Wuerzburg, Wuerzburg, Germany. kim_m@chirurgie.uni-wuerzburg.de
Reibetanz
J
J
Boenicke
L
L
Germer
C-T
CT
Jayne
D
D
Isbert
C
C
D000203:Activities of Daily Living; D000368:Aged; D012809:Colon, Sigmoid / Q000601:surgery*; D003248:Constipation / Q000209:etiology / Q000601:surgery*; D005242:Fecal Incontinence / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D011788:Quality of Life; D012005:Rectal Prolapse / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation