Comparison of quality of life, symptom and functional outcomes following surgical treatment for colorectal neoplasia

Christine Georges; Raymond Yap; Stephen Bell; Keith Chip Farmer; Lauren C L Cohen; Simon Wilkins; Suellyn Centauri; Rebekah Engel; Karen Oliva; Paul J McMurrick

doi:10.1111/ans.18510

Comparison of quality of life, symptom and functional outcomes following surgical treatment for colorectal neoplasia

ANZ J Surg. 2023 Jul-Aug;93(7-8):1877-1884. doi: 10.1111/ans.18510. Epub 2023 May 12.

Authors

Christine Georges^{1

2}, Raymond Yap¹, Stephen Bell^{1

3}, Keith Chip Farmer^{1

3}, Lauren C L Cohen¹, Simon Wilkins^{1

4}, Suellyn Centauri¹, Rebekah Engel^{1

5

6}, Karen Oliva^{1

3}, Paul J McMurrick¹

Affiliations

¹ Cabrini Monash University Department of Surgery, Cabrini Hospital, Malvern, Victoria, Australia.
² Department of Medicine, Alfred Hospital, Melbourne, Victoria, Australia.
³ Department of Colorectal and General Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
⁴ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
⁵ Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia.
⁶ Stem Cells and Development Program, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.

PMID: 37173802
DOI: 10.1111/ans.18510

Abstract

Background: Colorectal surgical procedures can have a significant impact on quality-of-life (QoL), functional and symptom outcomes. This retrospective study conducted in a tertiary care center evaluated the influence of four colorectal surgical procedures on patient-reported outcome measures (PROMs).

Methods: 512 patients undergoing colorectal neoplasia surgery between June 2015 and December 2017 were identified via the Cabrini Monash Colorectal Neoplasia database. Primary outcomes measured were the mean changes in PROMs following surgery utilizing the International Consortium of Health Outcome Measures colorectal cancer (CRC) PROMs.

Results: 242 patients from 483 eligible patients responded (50% participation rate). Responders and non-responders were comparable in median age (72 vs. 70 years), gender (48% vs. 52% male), time from surgery (<1 and >1 year), overall stage at diagnosis and type of surgery. Respondents underwent either a right hemicolectomy, ultra-low anterior resection, abdominoperineal resection or a transanal endoscopic microsurgery/transanal minimally invasive surgery. Right hemicolectomy patients reported the best post-operative function and reduced symptoms, significantly better (P < 0.01) than ultra-low anterior resection patients who reported the worst outcomes in multiple areas (body image, embarrassment, flatulence, diarrhoea, stool frequency). Furthermore, patients undergoing an abdominoperineal resection reported the worst scores for body image, urinary frequency, urinary incontinence, buttock pain, faecal incontinence and male impotence.

Conclusions: The differences in PROMs in CRC surgical procedures is demonstrable. The worst post-operative functional and symptom scores were reported after either an ultra-low anterior resection or an abdominoperineal resection. Implementation of PROMs will identify and aid early patient referral to allied health and support services.

Keywords: colorectal cancer; patient-reported outcome measures; quality of life; surgery.

MeSH terms

Colectomy
Colorectal Neoplasms* / surgery
Endoscopy
Female
Humans
Male
Postoperative Complications / epidemiology
Postoperative Complications / surgery
Quality of Life
Rectal Neoplasms* / surgery
Retrospective Studies
Treatment Outcome

Abstract

MeSH terms

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