title: Elective subtotal colectomy with ileosigmoid anastomosis for colon cancer preserves bowel function and quality of life.
abstract: OBJECTIVE
  We report on our experience of elective subtotal colectomy and ileosigmoid anastomosis for colon cancer with focus on postoperative results, function and quality of life.
  
  
  METHODS
  Between 1998 and 2011, 106 consecutive patients with colonic malignancy underwent this procedure electively. Function and quality of life (EORTC QLQ-C30) were evaluated retrospectively with questionnaires sent to all patients free of recurrence.
  
  
  RESULTS
  There were 62 men and 44 women (mean age 63 years). Postoperative mortality and morbidity rates were 1.9 and 26.4%, respectively. Persistent ileus was the main early complication (16%). After a mean follow-up of 67 ± 36 months, 50 (78.1) out of 64 patients have been evaluated for function and quality of life. The mean number of bowel movements per 24 h was 3 ± 2 and significantly lower when the length of the remaining sigmoid colon was more than 15 cm (P = 0.049). Compared with a European reference population for EORTC QLQ-C30 results, our patients had significantly more diarrhoea (26 vs 3, P = 0.0002) but less pain (10 vs 25, P < 0.0001) and better global quality of life (77 vs 62, P < 0.0001).
  
  
  CONCLUSIONS
  Elective subtotal colectomy for colon cancer is safe and associated with good function and quality of life. Ileosigmoid anastomosis should be discussed when extended colectomy is required, providing the rectosigmoid junction and its vascular supply can be oncologically preserved. For tumours located in the transverse colon or at the splenic flexure, this procedure may be the best surgical option.
authors.affiliation: Department of Digestive and Hepato-Pancreato-Biliary Surgery, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France; University Institute of Cancerology (Paris VI), Pierre & Marie Curie University, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Manceau
authors.forename: E
authors.initials: E
authors.lastname: d'Annunzio
authors.forename: M
authors.initials: M
authors.lastname: Karoui
authors.forename: S
authors.initials: S
authors.lastname: Breton
authors.forename: G
authors.initials: G
authors.lastname: Rousseau
authors.forename: A S
authors.initials: AS
authors.lastname: Blanchet
authors.forename: J C
authors.initials: JC
authors.lastname: Vaillant
authors.forename: L
authors.initials: L
authors.lastname: Hannoun
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D002277:Carcinoma / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D012809:Colon, Sigmoid / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery*; D003672:Defecation / Q000502:physiology; D017558:Elective Surgical Procedures; D005242:Fecal Incontinence / Q000517:prevention & control; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D045823:Ileus / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Subtotal colectomy; colon cancer; elective surgery; functional outcomes; ileosigmoid anastomosis; quality of life