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BACKGROUND: Despite advances in neoadjuvant treatment, rectal resection remains the gold-standard treatment for rectal cancer. AIM: The aim of this study was to assess the benefits of anal sphincter preservation and to compare the quality of life in terms of functional outcome in long term survivors who underwent low (or ultra low) anterior resection with total mesorectal excision to patients with abdominoperineal excision for locally advanced rectal cancer with neoadjuvant therapy. MATERIAL AND METHODS: We retrospectively analyzed the medical records of 319 patients who underwent surgery for rectal cancer from 2006 to 2011. Quality of life in 69 eligible patients with preoperative treatment and rectal resection with total mesorectal excision was assessed using the EORTC QLQ C 30 and EORTC QLQ CR29 questionnaires. We evaluated the overall status of quality of life and functional status of these patients symptoms scale. High score for functional scores shows better function whereas high symptom score shows more problems. Results were compared for patients with anal sphincter preservation (SP, 20 patients) versus abdominoperineal excision (APE, 49 patients) using t-Student test for independent samples. RESULTS: The median follow up in 69 patients was 32 months (range 11-74 months, 32±2,3SD). Quality of life for our group is significantly higher than the reference EORTC population (P <  0.001). Physical functioning (P = 0.050), cognitive functioning (P = 0.039), emotional functioning (P = 0.006), physical and social functioning (P = 0.005), constipation (P = 0.018), body image (P = 0.003), abdominal pain (P = 0.004), embarrassment (P = 0.003) were significantly better for patients with SP. There was no significant differences in the general symptoms of the radiochemotherapy treatment (mouth dryness, hair loss, flavor). Most of the symptom scales like sexual interest, impotence, dyspareunia, diarrhoea did not differ. APE patients suffered more from anxiety (P = 0.020). CONCLUSIONS: Patients after APE have restrictions in their postoperative quality of life. Although avoidance of a permanent colostomy is regarded as beneficial for patient´s quality of life by most surgeons, patients undergoing sphincter sparing surgery may develop a number of functional problems

jurnal de chirurgie

QUALITY OF LIFE OF PATIENTS WITH LOCALLY ADVANCED RECTAL CANCER: ANTERIOR RECTAL RESECTION WITH COLORECTAL ANASTOMOSIS VERSUS ABDOMINOPERINEAL EXCISION