Functional results and quality of life for patients with very low rectal cancer undergoing coloanal anastomosis or perineal colostomy with colonic muscular graft

Pocard, M.; Sideris, L.; Zenasni, F.; Duvillard, P.; Boige, V.; Goéré, D.; Elias, D.; Malka, D.; Ducreux, M.; Lasser, P.

doi:10.1016/j.ejso.2006.10.023

« Previous Next »European Journal of Surgical Oncology
Volume 33, Issue 4 , Pages 459-462, May 2007

Functional results and quality of life for patients with very low rectal cancer undergoing coloanal anastomosis or perineal colostomy with colonic muscular graft

M. Pocard
- Department of Surgical Oncology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France
- Corresponding author. Tel.: +33 1 42 11 42 11; fax: +33 1 42 11 52 13.
L. Sideris
- Department of Surgical Oncology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France
F. Zenasni
- Department of Psycho-oncology, Institut Gustave Roussy, Villejuif, France
P. Duvillard
- Department of Histology, Institut Gustave Roussy, Villejuif, France
V. Boige
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
D. Goéré
- Department of Surgical Oncology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France
D. Elias
- Department of Surgical Oncology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France
D. Malka
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
M. Ducreux
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
P. Lasser
- Department of Surgical Oncology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

Accepted 11 October 2006.

Abstract

Background

The aim of this study was to compare functional results and quality of life (QoL) of two salvage techniques: coloanal anastomosis (CAA) or perineal reconstruction after abdominoperineal resection for very low rectal cancer.

Methods

Between 1991 and 2001, 50 patients were operated for a very low rectal adenocarcinoma and analyzed after a follow-up greater than one year and because there was no relapse or no treatment, they were included in the analysis. Thirty-eight patients had a CAA, including: straight anastomosis (n=23), J pouch (n=10), coloplasty (n=2) and intersphincteric resection (n=3). Twelve patients underwent a PC.

Results

Vaizey's incontinence score was equivalent for the two groups: CAA 12 (0–22) versus PC 11 (8–13). The only differences were more frequent fractioned stools for the CAA group and increased pad soiling for the PC group. Overall QoL scores (QLQ C-30) were equivalent for CAA and PC.

Conclusions

For very low rectal tumors, the choice of surgical technique must be based on oncologic rather than future functional or QoL criteria, because both approaches seem to provide similar results.

Keywords: Rectal carcinoma, Quality of life, Functional result, Low rectal cancer, Surgical technique