title: Complications after surgery for colorectal cancer affect quality of life and surgeon-patient relationship.
abstract: OBJECTIVE
  This multicentric prospective study aimed to investigate how postoperative complications after surgery for colorectal cancer affect patients' quality of life and satisfaction with care.
  
  
  METHODS
  One hundred and sixteen patients operated on for colorectal cancer were enrolled in this study. Patients answered three questionnaires about generic (EORTC QLQ-C30) and disease-specific (EORTC QLQ-CR29) quality of life and treatment satisfaction (EORTC IN-PATSAT32) at the time of admission and at 1 and 6 months after surgery. Non-parametric tests and linear multiple regression models were used for statistical analysis.
  
  
  RESULTS
  Twelve patients had complications requiring further surgery (anastomotic leakage, abdominal bleeding, abdominal wall sepsis, wound infection). Patients with complications that required surgery reported a worse score of physical function, emotional function and anxiety than patients without such complications 1 month after surgery. These patients judged their general satisfaction with the quality of care and doctors' interpersonal skills, technical skills, information provision and availability to be worse than in patients without such complications. The presence of postoperative psychiatric complications and anastomotic leakage were independent predictors of quality of life (β = -0.30, P = 0.004, and β = -0.42, P < 0.001).
  
  
  CONCLUSIONS
  In patients undergoing surgery for colorectal cancer, complications requiring any kind of surgical management significantly affected patients' perception of all doctor-related items suggesting an impairment of the entire surgeon-patient relationship. Convincing patients that 'zero risk' cannot be achieved in surgical practice is therefore a priority.
authors.affiliation: General Surgery Unit, Nottola Hospital, Montepulciano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Di Cristofaro
authors.forename: C
authors.initials: C
authors.lastname: Ruffolo
authors.forename: E
authors.initials: E
authors.lastname: Pinto
authors.forename: M
authors.initials: M
authors.lastname: Massa
authors.forename: M
authors.initials: M
authors.lastname: Antoniutti
authors.forename: M
authors.initials: M
authors.lastname: Cagol
authors.forename: M
authors.initials: M
authors.lastname: Massani
authors.forename: R
authors.initials: R
authors.lastname: Alfieri
authors.forename: A
authors.initials: A
authors.lastname: Costa
authors.forename: N
authors.initials: N
authors.lastname: Bassi
authors.forename: C
authors.initials: C
authors.lastname: Castoro
authors.forename: M
authors.initials: M
authors.lastname: Scarpa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000523:psychology; D001007:Anxiety / Q000209:etiology; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D019106:Postoperative Hemorrhage / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation / Q000523:psychology; D018805:Sepsis / Q000523:psychology; D013530:Surgical Wound Infection / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Colorectal cancer; laparoscopic assisted colonic resection; quality of life