Quality of Life After Surgery for Rectal Cancer: a Comparison of Functional Outcomes After Transanal and Laparoscopic Approaches

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2019 Jan 4

PMID 30603861

Citations 22

Authors

Maya Xania Bjoern

Sarah Nielsen

Sharaf Karim Perdawood

Affiliations

Soon will be listed here.

Abstract

Background: The aim in rectal cancer surgery is to cure with minimal impact on the quality of life. Transanal total mesorectal excision (TaTME) seems to be a safe and feasible alternative to laparoscopic TME (LaTME). However, limited data are available on the functional outcomes after TaTME. We aimed to study the quality of life (QoL), through questionnaires, comparing different functional outcomes after TaTME and LaTME.

Methods: Consecutive patients who underwent TME between 2010 and 2017 at Slagelse Hospital, Denmark, were included based on certain criteria. Patients were divided according to the surgical technique (TaTME vs LaTME). The study was based on telephone interviews using the questionnaires: EORTC-QLQ C30, EORTC-QLQ C29, Low Anterior Resection Syndrome (LARS) score, and International Prostate Symptom Score (IPSS) for male patients. Patients in this study had a follow-up time of at least 8 months.

Results: Overall, global health status was similar between the groups (p = 0.625). Anorectal symptoms were significantly in disfavor of TaTME including buttock pain (p = 0.011), diarrhea (p = 0.009), clustering of stools (p = 0.017), and urgency (p = 0.032), yet total LARS score was comparable (p = 0.054). We found comparable sexual results and an overall higher satisfaction with urinary status in TaTME group (p = 0.010), yet no difference in IPSS symptoms (p = 0.236).

Conclusions: Anorectal dysfunction may occur after total mesorectal excision (TME) regardless of surgical technique, frequently more in after TaTME. The LARS symptoms and the overall quality of life status were however comparable. TaTME had a positive impact on the reported QoL, related to urinary symptoms.

Citing Articles

The Frequency of Urination Dysfunction in Patients Operated on for Rectal Cancer: A Systematic Review with Meta-Analyses.

Agustsdottir D, Oberg S, Christophersen C, Oggesen B, Rosenberg J Curr Oncol. 2024; 31(10):5929-5942.

PMID: 39451746 PMC: 11505854. DOI: 10.3390/curroncol31100442.

Quality of life and functional outcomes after laparoscopic total mesorectal excision (LaTME) and transanal total mesorectal excision (taTME) for rectal cancer. an updated meta-analysis.

Lauricella S, Brucchi F, Carrano F, Cassini D, Cirocchi R, Sylla P Int J Colorectal Dis. 2024; 39(1):129.

PMID: 39120642 PMC: 11315702. DOI: 10.1007/s00384-024-04703-x.

Laparoscopic total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer: A systematic review and meta-analysis.

Yi Chi Z, Gang O, Xiao Li F, Ya L, Zhijun Z, Yong Gang D Medicine (Baltimore). 2024; 103(4):e36859.

PMID: 38277570 PMC: 10817019. DOI: 10.1097/MD.0000000000036859.

A systematic review and meta-analysis of minimally invasive total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer.

Yong Gang D, Dong L, Dechun Z, Yichi Z, Ya L Front Oncol. 2023; 13:1167200.

PMID: 37377919 PMC: 10291686. DOI: 10.3389/fonc.2023.1167200.

The Quality of Life of Patients with Surgically Treated Colorectal Cancer: A Narrative Review.

Swiatkowski F, Gornicki T, Buldys K, Chabowski M J Clin Med. 2022; 11(20).

PMID: 36294531 PMC: 9604858. DOI: 10.3390/jcm11206211.

References

Rasmussen O, Petersen I, Christiansen J . Anorectal function following low anterior resection. Colorectal Dis. 2003; 5(3):258-61. DOI: 10.1046/j.1463-1318.2003.00439.x. View

Fazio V, Zutshi M, Remzi F, Parc Y, Ruppert R, Furst A . A randomized multicenter trial to compare long-term functional outcome, quality of life, and complications of surgical procedures for low rectal cancers. Ann Surg. 2007; 246(3):481-8. PMC: 1959344. DOI: 10.1097/SLA.0b013e3181485617. View

Nagtegaal I, Quirke P . What is the role for the circumferential margin in the modern treatment of rectal cancer?. J Clin Oncol. 2008; 26(2):303-12. DOI: 10.1200/JCO.2007.12.7027. View

Quirke P, Steele R, Monson J, Grieve R, Khanna S, Couture J . Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet. 2009; 373(9666):821-8. PMC: 2668948. DOI: 10.1016/S0140-6736(09)60485-2. View

Bruheim K, Guren M, Skovlund E, Hjermstad M, Dahl O, Frykholm G . Late side effects and quality of life after radiotherapy for rectal cancer. Int J Radiat Oncol Biol Phys. 2009; 76(4):1005-11. DOI: 10.1016/j.ijrobp.2009.03.010. View

Whistance R, Conroy T, Chie W, Costantini A, Sezer O, Koller M . Clinical and psychometric validation of the EORTC QLQ-CR29 questionnaire module to assess health-related quality of life in patients with colorectal cancer. Eur J Cancer. 2009; 45(17):3017-26. DOI: 10.1016/j.ejca.2009.08.014. View

Allaix M, Rebecchi F, Giaccone C, Mistrangelo M, Morino M . Long-term functional results and quality of life after transanal endoscopic microsurgery. Br J Surg. 2011; 98(11):1635-43. DOI: 10.1002/bjs.7584. View

Emmertsen K, Laurberg S . Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg. 2012; 255(5):922-8. DOI: 10.1097/SLA.0b013e31824f1c21. View

Andersson J, Angenete E, Gellerstedt M, Angeras U, Jess P, Rosenberg J . Health-related quality of life after laparoscopic and open surgery for rectal cancer in a randomized trial. Br J Surg. 2013; 100(7):941-9. PMC: 3672685. DOI: 10.1002/bjs.9144. View

10.

Emmertsen K, Laurberg S . Impact of bowel dysfunction on quality of life after sphincter-preserving resection for rectal cancer. Br J Surg. 2013; 100(10):1377-87. DOI: 10.1002/bjs.9223. View

11.

Chen T, Wiltink L, Nout R, Meershoek-Klein Kranenbarg E, Laurberg S, Marijnen C . Bowel function 14 years after preoperative short-course radiotherapy and total mesorectal excision for rectal cancer: report of a multicenter randomized trial. Clin Colorectal Cancer. 2015; 14(2):106-14. DOI: 10.1016/j.clcc.2014.12.007. View

12.

Juul T, Battersby N, Christensen P, Janjua A, Branagan G, Laurberg S . Validation of the English translation of the low anterior resection syndrome score. Colorectal Dis. 2015; 17(10):908-16. DOI: 10.1111/codi.12952. View

13.

Bjorn M, Perdawood S . Transanal total mesorectal excision--a systematic review. Dan Med J. 2015; 62(7). View

14.

Lacy A, Tasende M, Delgado S, Fernandez-Hevia M, Jimenez M, de Lacy B . Transanal Total Mesorectal Excision for Rectal Cancer: Outcomes after 140 Patients. J Am Coll Surg. 2015; 221(2):415-23. DOI: 10.1016/j.jamcollsurg.2015.03.046. View

15.

Simillis C, Hompes R, Penna M, Rasheed S, Tekkis P . A systematic review of transanal total mesorectal excision: is this the future of rectal cancer surgery?. Colorectal Dis. 2015; 18(1):19-36. DOI: 10.1111/codi.13151. View

16.

Kneist W, Wachter N, Paschold M, Kauff D, Rink A, Lang H . Midterm functional results of taTME with neuromapping for low rectal cancer. Tech Coloproctol. 2015; 20(1):41-9. DOI: 10.1007/s10151-015-1390-6. View

17.

Perdawood S, Al Khefagie G . Transanal vs laparoscopic total mesorectal excision for rectal cancer: initial experience from Denmark. Colorectal Dis. 2015; 18(1):51-8. DOI: 10.1111/codi.13225. View

18.

Jimenez-Gomez L, Espin-Basany E, Marti-Gallostra M, Sanchez-Garcia J, Vallribera-Valls F, Armengol-Carrasco M . Low anterior resection syndrome: a survey of the members of the American Society of Colon and Rectal Surgeons (ASCRS), the Spanish Association of Surgeons (AEC), and the Spanish Society of Coloproctology (AECP). Int J Colorectal Dis. 2016; 31(4):813-23. DOI: 10.1007/s00384-016-2511-z. View

19.

Pontallier A, Denost Q, Van Geluwe B, Adam J, Celerier B, Rullier E . Potential sexual function improvement by using transanal mesorectal approach for laparoscopic low rectal cancer excision. Surg Endosc. 2016; 30(11):4924-4933. DOI: 10.1007/s00464-016-4833-x. View

20.

Battersby N, Juul T, Christensen P, Janjua A, Branagan G, Emmertsen K . Predicting the Risk of Bowel-Related Quality-of-Life Impairment After Restorative Resection for Rectal Cancer: A Multicenter Cross-Sectional Study. Dis Colon Rectum. 2016; 59(4):270-80. DOI: 10.1097/DCR.0000000000000552. View