title: Self-reported wellbeing and body image after abdominoperineal excision for rectal cancer.
abstract: OBJECTIVE
  Patients with low rectal cancer are often operated with an abdominoperineal excision (APE) rendering them a permanent stoma. The surgical procedure itself, the cancer diagnosis, and the permanent stoma might all affect quality of life. The aim of this study was to explore wellbeing and body image 3 years after APE in a population-based cohort of patients.
  
  
  METHODS
  All patients with rectal cancer operated with an APE between 2007 and 2009 were identified using the Swedish ColoRectal Cancer Registry. A total of 545 patients answered a questionnaire 3 years after surgery. Two open-ended questions were analyzed with a mixed method design using both qualitative and quantitative content analysis. Main themes and sub-themes on wellbeing and body image were identified.
  
  
  RESULTS
  Three main themes were identified: bodily limitations, mental suffering, and acceptance. Bodily limitations included other symptoms than stoma-related problems. A majority of patients expressed acceptance to their situation regardless of bodily limitations and mental suffering. However, 18 % did not describe any acceptance of their current situation.
  
  
  CONCLUSIONS
  Most patients expressed acceptance reflecting wellbeing 3 years after APE for rectal cancer. There is, however, a subset of patients (18 %) who describe bodily limitations and mental suffering without acceptance and who require further support. Many aspects of the portrayed bodily limitations and mental suffering could be prevented or treated.
  
  
  BACKGROUND
  NCT01296984.
authors: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden. elisabeth.gonzales@vgregion.se.
authors: Elisabeth
authors: http://orcid.org/0000-0003-0939-2226
authors: E
authors: González
authors: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden.
authors: Kajsa
authors: K
authors: Holm
authors: Department of Surgery, Skaraborgs Hospital, Skövde, Sweden.
authors: Berith
authors: B
authors: Wennström
authors: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden.
authors: Eva
authors: E
authors: Haglind
authors: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden.
authors: Eva
authors: E
authors: Angenete
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D001828:Body Image; D005260:Female; D006262:Health; D006801:Humans; D008297:Male; D010502:Perineum / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Body image; Ostomy; Quality of life; Rectal neoplasm