Symptoms affecting quality of life after sphincter-saving rectal cancer surgery: A systematic review

Purpose: Rectal cancer is common and is frequently treated with surgery which removes the rectum but retains anal sphincters. After sphincter-saving rectal cancer surgery, which can result in a reduced rectal storage capacity and nerve damage, symptoms frequently occur. Method: A systematic review was undertaken to determine which symptoms occur and their effect on quality of life. Data from questionnaires and interviews were analysed thematically. Results: Fourteen heterogeneous studies were identified reporting both qualitative and quantitative data on over 1700 individuals. The most commonly reported symptoms related to bowel changes. The most problematic changes were bowel and sexual dysfunction. Quality of life was most affected by an inability to function as individuals desired, specifically in their chosen role and socially. Quality of life improved as time progressed or symptoms resolved; but symptoms could persist for many years. Conclusion: After sphincter-saving rectal cancer surgery quality of life is affected by symptoms such as bowel dysfunction. Healthcare professionals need to gain a better understanding of which symptoms most bother individuals to enable patient-focussed interventions to be planned and improve quality of life.