The Quality of Life after Rectal Cancer Surgery

Kim, Jong Woo

Abstract

Surgery is a definite treatment for rectal cancer by resecting the tumor. Surgeon not only aims to cure the patient but aims to relieve distressing symptoms as well. Unfortunately, patients may suffer adverse consequences from such surgery. The operative dissection of the rectum may damage the pelvic autonomic nerves disturbing bladder and sexual function. The construction of a permanent colostomy following an abdominoperineal resection may be associated with one or more physical problems as well as clinically significant psychosocial problems as well. The advances in knowledge of tumor biology and the improvements of surgical techniques and devices result in an increasing number of sphincter saving procedures such as low anterior resection. Although avoiding permanent stoma is generally regarded as a favorable outcome measure, patients undergoing sphincter-saving surgery may develop a number of unpleasant symptoms, typically fecal soiling and urgency, especially with low anastomosis. It is evident that the consequences of rectal surgery have an important bearing on quality of life. Although differences in definition exist, quality of life may be regarded as representing an individual's ability to carry out daily activities, as well as satisfaction with personal performance and with balance between disease control and adverse effects of treatment. In addition to traditional endpoints, such as survival and disease recurrences, assessing quality of life is necessary to provide a proper, comprehensive understanding of the outcome of surgery and other forms of treatment.