Quality of life after rectal cancer surgery

Multimodal treatment of advanced rectal cancer involves excision of the rectum in conjunction with pelvic radiotherapy and chemotherapy. Outcome assessment in oncologic surgery for rectal cancer has conventionally included data regarding perioperative mortality and morbidity, disease recurrence, and long-term survival. Throughout the past decade however research has increased in the field of patient-reported outcome, and quality of life (QoL) is now regarded as a key measurement in assessing outcomes of interventions. The aim of this review paper was to evaluate QoL assessment in different aspects of rectal surgery. In general patients undergoing abdominoperineal excision with permanent colostomy did not have poorer QoL measures than those undergoing anterior resection. Reversal of a dysfunctional loop ileostomy in surgery for low rectal cancer improves most patients' overall QoL. The previously reported short- and long-term QoL analysis of laparoscopic vs conventional open rectal surgery revealed no significant differences. In patients undergoing restorative resection for low rectal cancer, colonic J pouches offer significant advantages in function and QoL over straight anastomosis or coloplasty.