Comparison of overall survival and quality of life between patients undergoing anal reconstruction and patients undergoing traditional lower abdominal stoma after radical resection
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Miles procedure is often necessary for patients with low rectal carcinoma. However, this operation often affects the quality of life of patients, to evaluate the advantages of improved operation (anal reconstruction), the quality of life and survival between patients undergoing anal reconstruction and patients undergoing traditional lower abdominal stoma after radical resection were analyzed.
The clinical data of 43 patients with low situated rectal carcinoma were retrospectively analyzed. 23 patients with left lower abdominal stoma after radical resection (Miles procedure) were divided into group A, and 20 patients with reconstruction of the anus in situ after radical resection were in group B. All patients were investigated by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR38 questionnaire, the clinical data are recorded. Independent sample T test was used to analyze the difference in quality of life between group A and group B at 3, 6, and 12 months after surgery, and Kaplan–Meier was used to compare the difference in overall survival between group A and group B.
The results of T test showed that there were statistical significance in global health status and physical functioning between group A and group B at 3 and 6 months, but no statistical significance at 12 months (P = 0.024, P = 0.019, P = 0.115 for global health status; P = 0.004, P = 0.006, P = 0.065 for physical functioning, respectively). Emotional functioning and social functioning were also statistically significant between group A and group B at 3, 6, and 12 months (P = 0.041, P = 0.040, P = 0.034 for Emotional functioning; P = 0.020, P = 0.009, P = 0.032 for social functioning, respectively). This study also found that there was no statistical significance in body image and sexual functioning between group A and group B at 3 months, but there was statistical significance at 6 and 12 months(P = 0.098, P = 0.035, P = 0.045 for body image; P = 0.110, P = 0.048, P = 0.047 for sexual functioning, respectively). There were statistically significant about sexual enjoyment and defecation problems at 3, 6, and 12 months (P = 0.023, P = 0.028, P = 0.050 for sexual enjoyment; P = 0.013, P = 0.011, P = 0.050 for defecation problems, respectively).The results of Kaplan–Meier showed that the overall survival (OS) between group A and group B was not statistically significant (χ2 = 0.600, P = 0.439).
There was no difference in survival time between group A and group B, but compared with the patients with left lower abdominal stoma(group A), the quality of life was better in patients with reconstruction of the anus in situ (group B). It is significant to improve the traditional lower abdominal stoma operation.
KeywordsEORTC QLQ-C30 EORTC QLQ-C38 Anal reconstruction Ostomy Rectal carcinoma
This work was supported by grants from the scientific research project of Gansu health industry (No. GSWST2013-03).
Compliances with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest concerning this article.
The study was approved by the Ethics Committee of the Second Hospital of Lanzhou University, and the data were anonymously obtained and retrospectively analyzed. The clinical data of all patients were collected from the electronic medical records of the Second Hospital of Lanzhou University. This study was performed in accordance with the relevant guidelines and regulations, and conformed to the Declaration of Helsinki.
Informed consents from participants were also waived due to the complete anonymity of the patients.
- 14.Sprangers MA, te Velde A, Aaronson NK. The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR14). European Organization for Research and Treatment of Cancer Study Group on Quality of Life[J]. Eur J Cancer. 1999;35(2):238–47.CrossRefPubMedGoogle Scholar
- 15.Lin JK, Tan EC, Yang MC. Comparing the effectiveness of capecitabine versus 5-fluorouracil/leucovorin therapy for elderly Taiwanese stage III colorectal cancer patients based on quality-of-life measures (QLQ-C30 and QLQ-CR1) and a new cost assessment tool[J]. Health Qual Life Outcomes. 2015;13:61.CrossRefPubMedPubMedCentralGoogle Scholar
- 16.World Medical A. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects[J]. Bull World Health Organ. 2001;79(4):373–4.Google Scholar
- 18.The World Cancer. Report—the major findings[J]. Cent. Eur J Public Health. 2003;11(3):177–9.Google Scholar
- 19.Reinwalds M, Blixter A, Carlsson E. A descriptive, qualitative study to assess patient experiences following stoma reversal after rectal cancer surgery[J]. Ostomy Wound Manag. 2017;63(12):29–37.Google Scholar