Long-term functional and quality of life outcomes after coloanal anastomosis for distal rectal cancer

Imran Hassan, David W. Larson, Robert R. Cima, Janette U. Gaw, Heidi K. Chua, Dieter Hahnloser, John M. Stulak, Megan M. O'Byrne, Dirk R. Larson, Bruce G. Wolff, John H. Pemberton

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

PURPOSE: This study was designed to evaluate the long-term functional and quality-of-life outcomes of patients after coloanal anastomosis for distal rectal cancer. METHODS: A total of 192 patients underwent coloanal anastomosis between 1982 and 2001 at two tertiary referral institutions. Standardized and validated questionnaires to assess functional and quality-of-life outcomes were mailed to 151 patients, of which 121 patients responded (median follow-up, 65 months). RESULTS: Patients receiving pelvic radiotherapy had more bowel function problems than patients who did not receive pelvic radiotherapy. No significant differences in relevant functional and quality-of-life outcomes were seen among patients who received preoperative or postoperative pelvic radiotherapy. Patients requiring permanent diversion as a result of complications of the surgery had decreased quality of life. CONCLUSIONS: Coloanal anastomosis for distal rectal cancer has favorable long-term outcomes. Pelvic radiotherapy has an adverse effect on subsequent bowel function (whether given preoperatively or postoperatively) in patients who maintain intestinal continuity. Loss of intestinal continuity after a coloanal anastomosis is associated with diminished quality of life.

Original languageEnglish (US)
Pages (from-to)1266-1274
Number of pages9
JournalDiseases of the colon and rectum
Volume49
Issue number9
DOIs
StatePublished - Sep 1 2006

Keywords

  • Coloanal anastomosis
  • Complications
  • Distal rectal cancer
  • Functional outcomes
  • Pelvic radiotherapy
  • Quality of life

ASJC Scopus subject areas

  • Gastroenterology

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