Major low anterior resection syndrome has equivalent health-related quality of life implications as having a permanent colostomy
Background The literature is inconclusive when comparing health-related quality of life following restorative anterior resection (AR) compared with abdominoperineal resection (APR). Consideration of functional outcomes may explain this inconsistency. The aim of this study was to compare health-relat...
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| Veröffentlicht in: | Techniques in coloproctology 2024-12, Vol.28 (1), p.17, Article 17 |
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| creator | Koneru, S. Builth-Snoad, L. Rickard, M. J. F. X. Keshava, A. Chapuis, P. H. Ng, K.-S. |
| description | Background
The literature is inconclusive when comparing health-related quality of life following restorative anterior resection (AR) compared with abdominoperineal resection (APR). Consideration of functional outcomes may explain this inconsistency. The aim of this study was to compare health-related quality of life in patients post-anterior resection, stratified by low anterior resection syndrome score, and post-abdominoperineal resection patients.
Methods
A cross-sectional study of consecutive patients post APR and AR for rectal or sigmoid adenocarcinoma at a tertiary centre in Sydney, Australia (Jan 2012- Dec 2021) was performed. HRQoL outcomes (SF36v2 physical [PCS] and mental component summary [MCS] scores) were compared between APR and AR patients, with subgroup analyses stratifying AR patients according to LARS score (no/minor/major). Age- and gender-adjusted comparisons were performed by linear regression.
Results
Overall, 248 post-AR patients (57.3% male, mean age 70.8 years, SD 11.6) and 64 post-APR patients (62.5% male, mean age 68.1 years, SD 13.1) participated. When stratified by LARS, ‘major LARS’ had a similar negative effect on age-and sex-adjusted PCS scores as APR. ‘No LARS’ (
p
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| doi_str_mv | 10.1007/s10151-023-02879-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2902955765</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2902955765</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-287d1fd3be1626e9b0d07dbeb7967d290502e9e3aad3f8716154f47f579fb8053</originalsourceid><addsrcrecordid>eNp9kUtv3CAURlHVqHm0f6CLCKmbbNyAGYxZVlFeUqpsEik7hM0lwwibGcCJvOtPLzOTNlIXXSBAnHvuRR9CXyn5TgkR54kSymlFalZWK2Q1f0BHlNZtRRb86ePuzKqGMXGIjlNaEUKF4PQTOmQtkVI29Aj9-qlXIWIfXrEeM0RXLhES9NmFEad5NDEMgJc6YdhM7kV7GDNegvZ5WUXwOoPBm0l7l2ccLPbOAnbD2rtebxUJl8qlfnHjM9Z4DXHQ49bQBx9SDsP8GR1Y7RN8edtP0OPV5cPFTXV3f3178eOu6pnguSr_M9Qa1gFt6gZkRwwRpoNOyEaYWhJOapDAtDbMtoI2lC_sQlgupO1awtkJOtt71zFsJkhZDS714H2ZJ0xJFUUtORfNFv32D7oKUxzLdDuKk5ZTVqh6T_UxpBTBqnV0g46zokRt81H7fFTJR-3yUXMpOn1TT90A5m_Jn0AKwPZAKk_jM8T33v_R_gZKn54a</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2902508513</pqid></control><display><type>article</type><title>Major low anterior resection syndrome has equivalent health-related quality of life implications as having a permanent colostomy</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Koneru, S. ; Builth-Snoad, L. ; Rickard, M. J. F. X. ; Keshava, A. ; Chapuis, P. H. ; Ng, K.-S.</creator><creatorcontrib>Koneru, S. ; Builth-Snoad, L. ; Rickard, M. J. F. X. ; Keshava, A. ; Chapuis, P. H. ; Ng, K.-S.</creatorcontrib><description>Background
The literature is inconclusive when comparing health-related quality of life following restorative anterior resection (AR) compared with abdominoperineal resection (APR). Consideration of functional outcomes may explain this inconsistency. The aim of this study was to compare health-related quality of life in patients post-anterior resection, stratified by low anterior resection syndrome score, and post-abdominoperineal resection patients.
Methods
A cross-sectional study of consecutive patients post APR and AR for rectal or sigmoid adenocarcinoma at a tertiary centre in Sydney, Australia (Jan 2012- Dec 2021) was performed. HRQoL outcomes (SF36v2 physical [PCS] and mental component summary [MCS] scores) were compared between APR and AR patients, with subgroup analyses stratifying AR patients according to LARS score (no/minor/major). Age- and gender-adjusted comparisons were performed by linear regression.
Results
Overall, 248 post-AR patients (57.3% male, mean age 70.8 years, SD 11.6) and 64 post-APR patients (62.5% male, mean age 68.1 years, SD 13.1) participated. When stratified by LARS, ‘major LARS’ had a similar negative effect on age-and sex-adjusted PCS scores as APR. ‘No LARS’ (
p
< 0.001) and ‘minor LARS’ (
p
< 0.001) patients had higher PCS scores compared to post-APR patients. ‘Major LARS’ had a similarly negative effect on MCS scores compared with post-APR patients. MCS scores were higher in ‘no LARS’ (
p
= 0.006) compared with APR patients.
Conclusions
Postoperative bowel dysfunction significantly impacts health-related quality of life. Patients with ‘major LARS’ have health-related quality of life as poor as those following APR. This requires consideration when counselling patients on postoperative health-related quality of life, especially where poor postoperative bowel function is anticipated following restorative surgery.</description><identifier>ISSN: 1123-6337</identifier><identifier>ISSN: 1128-045X</identifier><identifier>EISSN: 1128-045X</identifier><identifier>DOI: 10.1007/s10151-023-02879-y</identifier><identifier>PMID: 38099961</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Aged ; Colorectal cancer ; Colorectal Surgery ; Colostomy - adverse effects ; Cross-Sectional Studies ; Female ; Gastroenterology ; Humans ; Low Anterior Resection Syndrome ; Male ; Medicine ; Medicine & Public Health ; Original Article ; Postoperative Complications - etiology ; Proctology ; Quality of Life ; Rectal Neoplasms - surgery ; Surgery</subject><ispartof>Techniques in coloproctology, 2024-12, Vol.28 (1), p.17, Article 17</ispartof><rights>Springer Nature Switzerland AG 2023 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. Springer Nature Switzerland AG.</rights><rights>Copyright Springer Nature B.V. 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-287d1fd3be1626e9b0d07dbeb7967d290502e9e3aad3f8716154f47f579fb8053</citedby><cites>FETCH-LOGICAL-c375t-287d1fd3be1626e9b0d07dbeb7967d290502e9e3aad3f8716154f47f579fb8053</cites><orcidid>0000-0002-7614-855X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10151-023-02879-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10151-023-02879-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38099961$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koneru, S.</creatorcontrib><creatorcontrib>Builth-Snoad, L.</creatorcontrib><creatorcontrib>Rickard, M. J. F. X.</creatorcontrib><creatorcontrib>Keshava, A.</creatorcontrib><creatorcontrib>Chapuis, P. H.</creatorcontrib><creatorcontrib>Ng, K.-S.</creatorcontrib><title>Major low anterior resection syndrome has equivalent health-related quality of life implications as having a permanent colostomy</title><title>Techniques in coloproctology</title><addtitle>Tech Coloproctol</addtitle><addtitle>Tech Coloproctol</addtitle><description>Background
The literature is inconclusive when comparing health-related quality of life following restorative anterior resection (AR) compared with abdominoperineal resection (APR). Consideration of functional outcomes may explain this inconsistency. The aim of this study was to compare health-related quality of life in patients post-anterior resection, stratified by low anterior resection syndrome score, and post-abdominoperineal resection patients.
Methods
A cross-sectional study of consecutive patients post APR and AR for rectal or sigmoid adenocarcinoma at a tertiary centre in Sydney, Australia (Jan 2012- Dec 2021) was performed. HRQoL outcomes (SF36v2 physical [PCS] and mental component summary [MCS] scores) were compared between APR and AR patients, with subgroup analyses stratifying AR patients according to LARS score (no/minor/major). Age- and gender-adjusted comparisons were performed by linear regression.
Results
Overall, 248 post-AR patients (57.3% male, mean age 70.8 years, SD 11.6) and 64 post-APR patients (62.5% male, mean age 68.1 years, SD 13.1) participated. When stratified by LARS, ‘major LARS’ had a similar negative effect on age-and sex-adjusted PCS scores as APR. ‘No LARS’ (
p
< 0.001) and ‘minor LARS’ (
p
< 0.001) patients had higher PCS scores compared to post-APR patients. ‘Major LARS’ had a similarly negative effect on MCS scores compared with post-APR patients. MCS scores were higher in ‘no LARS’ (
p
= 0.006) compared with APR patients.
Conclusions
Postoperative bowel dysfunction significantly impacts health-related quality of life. Patients with ‘major LARS’ have health-related quality of life as poor as those following APR. This requires consideration when counselling patients on postoperative health-related quality of life, especially where poor postoperative bowel function is anticipated following restorative surgery.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Colorectal cancer</subject><subject>Colorectal Surgery</subject><subject>Colostomy - adverse effects</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Low Anterior Resection Syndrome</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Postoperative Complications - etiology</subject><subject>Proctology</subject><subject>Quality of Life</subject><subject>Rectal Neoplasms - surgery</subject><subject>Surgery</subject><issn>1123-6337</issn><issn>1128-045X</issn><issn>1128-045X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtv3CAURlHVqHm0f6CLCKmbbNyAGYxZVlFeUqpsEik7hM0lwwibGcCJvOtPLzOTNlIXXSBAnHvuRR9CXyn5TgkR54kSymlFalZWK2Q1f0BHlNZtRRb86ePuzKqGMXGIjlNaEUKF4PQTOmQtkVI29Aj9-qlXIWIfXrEeM0RXLhES9NmFEad5NDEMgJc6YdhM7kV7GDNegvZ5WUXwOoPBm0l7l2ccLPbOAnbD2rtebxUJl8qlfnHjM9Z4DXHQ49bQBx9SDsP8GR1Y7RN8edtP0OPV5cPFTXV3f3178eOu6pnguSr_M9Qa1gFt6gZkRwwRpoNOyEaYWhJOapDAtDbMtoI2lC_sQlgupO1awtkJOtt71zFsJkhZDS714H2ZJ0xJFUUtORfNFv32D7oKUxzLdDuKk5ZTVqh6T_UxpBTBqnV0g46zokRt81H7fFTJR-3yUXMpOn1TT90A5m_Jn0AKwPZAKk_jM8T33v_R_gZKn54a</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Koneru, S.</creator><creator>Builth-Snoad, L.</creator><creator>Rickard, M. J. F. X.</creator><creator>Keshava, A.</creator><creator>Chapuis, P. H.</creator><creator>Ng, K.-S.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7614-855X</orcidid></search><sort><creationdate>20241201</creationdate><title>Major low anterior resection syndrome has equivalent health-related quality of life implications as having a permanent colostomy</title><author>Koneru, S. ; Builth-Snoad, L. ; Rickard, M. J. F. X. ; Keshava, A. ; Chapuis, P. H. ; Ng, K.-S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-287d1fd3be1626e9b0d07dbeb7967d290502e9e3aad3f8716154f47f579fb8053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Colorectal cancer</topic><topic>Colorectal Surgery</topic><topic>Colostomy - adverse effects</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Low Anterior Resection Syndrome</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Postoperative Complications - etiology</topic><topic>Proctology</topic><topic>Quality of Life</topic><topic>Rectal Neoplasms - surgery</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koneru, S.</creatorcontrib><creatorcontrib>Builth-Snoad, L.</creatorcontrib><creatorcontrib>Rickard, M. J. F. X.</creatorcontrib><creatorcontrib>Keshava, A.</creatorcontrib><creatorcontrib>Chapuis, P. H.</creatorcontrib><creatorcontrib>Ng, K.-S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Techniques in coloproctology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koneru, S.</au><au>Builth-Snoad, L.</au><au>Rickard, M. J. F. X.</au><au>Keshava, A.</au><au>Chapuis, P. H.</au><au>Ng, K.-S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Major low anterior resection syndrome has equivalent health-related quality of life implications as having a permanent colostomy</atitle><jtitle>Techniques in coloproctology</jtitle><stitle>Tech Coloproctol</stitle><addtitle>Tech Coloproctol</addtitle><date>2024-12-01</date><risdate>2024</risdate><volume>28</volume><issue>1</issue><spage>17</spage><pages>17-</pages><artnum>17</artnum><issn>1123-6337</issn><issn>1128-045X</issn><eissn>1128-045X</eissn><abstract>Background
The literature is inconclusive when comparing health-related quality of life following restorative anterior resection (AR) compared with abdominoperineal resection (APR). Consideration of functional outcomes may explain this inconsistency. The aim of this study was to compare health-related quality of life in patients post-anterior resection, stratified by low anterior resection syndrome score, and post-abdominoperineal resection patients.
Methods
A cross-sectional study of consecutive patients post APR and AR for rectal or sigmoid adenocarcinoma at a tertiary centre in Sydney, Australia (Jan 2012- Dec 2021) was performed. HRQoL outcomes (SF36v2 physical [PCS] and mental component summary [MCS] scores) were compared between APR and AR patients, with subgroup analyses stratifying AR patients according to LARS score (no/minor/major). Age- and gender-adjusted comparisons were performed by linear regression.
Results
Overall, 248 post-AR patients (57.3% male, mean age 70.8 years, SD 11.6) and 64 post-APR patients (62.5% male, mean age 68.1 years, SD 13.1) participated. When stratified by LARS, ‘major LARS’ had a similar negative effect on age-and sex-adjusted PCS scores as APR. ‘No LARS’ (
p
< 0.001) and ‘minor LARS’ (
p
< 0.001) patients had higher PCS scores compared to post-APR patients. ‘Major LARS’ had a similarly negative effect on MCS scores compared with post-APR patients. MCS scores were higher in ‘no LARS’ (
p
= 0.006) compared with APR patients.
Conclusions
Postoperative bowel dysfunction significantly impacts health-related quality of life. Patients with ‘major LARS’ have health-related quality of life as poor as those following APR. This requires consideration when counselling patients on postoperative health-related quality of life, especially where poor postoperative bowel function is anticipated following restorative surgery.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>38099961</pmid><doi>10.1007/s10151-023-02879-y</doi><orcidid>https://orcid.org/0000-0002-7614-855X</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Techniques in coloproctology, 2024-12, Vol.28 (1), p.17, Article 17 |
| issn | 1123-6337 1128-045X 1128-045X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2902955765 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Aged Colorectal cancer Colorectal Surgery Colostomy - adverse effects Cross-Sectional Studies Female Gastroenterology Humans Low Anterior Resection Syndrome Male Medicine Medicine & Public Health Original Article Postoperative Complications - etiology Proctology Quality of Life Rectal Neoplasms - surgery Surgery |
| title | Major low anterior resection syndrome has equivalent health-related quality of life implications as having a permanent colostomy |
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