Abstract
Background
The aims of this cross-sectional study were to assess the long-term quality of life, the body image, and the cosmetic and functional results in patients who had laparoscopic-assisted for colorectal cancer.
Methods
Forty-two patients were enrolled in this study: 21 consecutive patients who had undergone laparoscopic-assisted colonic resection and 21 patients who had open colonic resection, selected according to stage, gender, age, cancer site, and type of resection. The patients answered four questionnaires about their quality of life, body image, functional, and cosmetic results. Nonparametric tests were used for statistical analysis.
Results
Postoperative hospital stay was shorter in patients who had laparoscopic-assisted resection. The cosmetic score was significantly better in the laparoscopic-assisted group than in the open group (p < 0.01). In spite of similar overall body image score, patients who had a laparoscopic-assisted resection reported a significantly better satisfaction with their own body (p = 0.05). Quality-of-life and functional results were similar in both groups.
Conclusions
The cosmetic results and the consequent satisfaction with the body were significantly better after laparoscopic assisted resection compared to equivalent open procedure. These effects seemed to be temporary but they could help patients to accept the burden of surgery.
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References
Weir HK, Thun MJ, Hankey BF et al (2003) Annual report to the nation on the status of cancer, 1975–2000, featuring the uses of surveillance data for cancer prevention and control. J Natl Cancer Inst 95:1276–1299
Greenlee RT, Hill-Harmon MB, Murray T et al (2001) Cancer statistics, 2001. CA Cancer J Clin 51:15–36
Becker N, Muscat JE, Wynder EL (2001) Cancer mortality in the United States and Germany. J Cancer Res Clin Oncol 127:293–300
Jehle EC, Haehnel T, Starlinger MJ et al (1995) Level of the anastomosis does not influence functional outcome after anterior rectal resection for rectal cancer. Am J Surg 169:147–152; discussion 152–153
Pahlman L (2001) The rectal cancer debate. Eur J Surg Oncol 27:439
Korolija D, Wood-Dauphinee S, Pointner R (2007) Patient-reported outcomes. How important are they? Surg Endosc 21(4):503–507
Sideris L, Zenasni F, Vernerey D, Dauchy S, Lasser P, Pignon JP, Elias D, Di Palma M, Pocard M (2005) Quality of life of patients operated on for low rectal cancer: impact of the type of surgery and patients’ characteristics. Dis Colon Rectum 48:2180–2219
McLeod RS (2001) Comparison of quality of life in patients undergoing abdominoperineal extirpation or anterior resection for rectal cancer. Ann Surg 233:157–158
The Colon cancer Laparoscopic or Open Resection Study Group (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6:477–84
Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AMH, Heath RM, Brown JM, for the MRC CLASICC trial group (2005) Short-term endpoints of conventional versus laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726
Cera SM, Wexner SD (2005) Minimally invasive treatment of colon cancer. Cancer J 11(1):26–35
Hopwood P (1993) The assessment of body image in cancer patients. Eur J Cancer 29A:276–281
Lasry JCM, Margolese RG, Poisson R, Shibata H, Pilch Y, Lerner H, Fisher B (1987) Depression and body image following mastectomy and lumpectomy. J Chron Dis 40:529–534
Sprangers MAG, Groenvold M, Arraras JI, Franklin J, Te Velde A, Muller M, Franzini L (1996) The European Organization for Research and Treatment of Cancer. Breast cancer–specific quality-of-life questionnaire module: first results from a three country field study. J Clin Oncol 14:2756–2768
Dunker MS, Stiggelbout AM, van Hogezand RA, Ringers J, Griffioen G, Bemelman WA (1998) Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn’s disease. Surg Endosc 12:1334–1340
Greene Fl, Page DL, Fleming ID et al (2002) AJCC Cancer Staging Manual, 6th edn. Springer-Verlag, New York, NY
Young-Fadok TM, Nelson H (2000) Laparoscopic right colectomy: five step procedure. Dis Colon Rectum 43:267–273
Scarpa M, Ruffolo C, Polese L, Martin A, D’Incà R, Sturniolo GC, D’Amico DF, Angriman I (2007) Quality of life after restorative proctocolectomy for ulcerative colitis: different questionnaires lead to different interpretations. Arch Surg 142(2):158–165
Apolone G, Mosconi P (1998) The Italian SF-36 Health Survey: translation, validation and norming. J Clin Epidemiol 51:1025–1036
Wong WD, Congliosi SM, Spencer MP et al (2002) The safety and efficacy of the artificial bowel sphincter for fecal incontinence: result from a multicenter cohort study. Dis Colon Rectum 45:1139–1153
Urso E, Serpentini S, Pucciarelli S, De Salvo GL, Friso ML, Fabris G, Lonardi S, Ferraro B, Bruttocao A, Aschele C, Nitti D (2006) Complications, functional outcome and quality of life after intensive preoperative chemoradiotherapy for rectal cancer. Eur J Surg Oncol 32(10):1201–1208
American Society of Colon and Rectum Surgeons (1994) Approved statement on laparoscopic colectomy. Dis Colon Rectum 37:8–12
The Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059
McLeod RS (1999) Quality of life measurement in the assessment of surgical outcome. Adv Surg 33:293–309
Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G (2002) Clinical Outcomes of Surgical Therapy (COST) Study Group. Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA 16;287(3):321–328
Korolija D, Sauerland S, Wood-Dauphinée S, Abbou CC, Eypasch E, Caballero MG, Lumsden MA, Millat B, Monson JR, Nilsson G, Pointner R, Schwenk W, Shamiyeh A, Szold A, Targarona E, Ure B, Neugebauer E; European Association for Endoscopic Surgery (2004) Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery. Surg Endosc 18(6):879–897
Dunker MS, Bemelman WA, Slors JF, van Duijvendijk P, Gouma DJ (2001) Functional outcome, quality of life, body image, and cosmesis in patients after laparoscopic-assisted and conventional restorative proctocolectomy: a comparative study. Dis Colon Rectum 44(12):1800–1807
Larson DW, Dozois EJ, Piotrowicz K, Cima RR, Wolff BG, Young-Fadok TM (2005) Laparoscopic-assisted vs. open ileal pouch-anal anastomosis: functional outcome in a case-matched series. Dis Colon Rectum 48(10):1845–1850
Scarpa M, Ruffolo C, D’Incà R, Filosa T, Bertin E, Ferraro S, Polese L, Martin A, Sturniolo GC, Frego M, D’Amico DF, Angriman I (2007) Health related quality of life after ileo-colonic resection for Crohn’s disease: long-term results. Inflam Bowel Dis 13(4):462–469
Scarpa M, Angriman I, Ruffolo C, Ferronato A, Polese L, Barollo M, Martin A, Sturniolo GC, D’Amico DF (2004) Health-related quality of life after restorative proctocolectomy for ulcerative colitis: long-term results. World J Surg 28(2):124–129
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Scarpa, M., Erroi, F., Ruffolo, C. et al. Minimally invasive surgery for colorectal cancer: quality of life, body image, cosmesis, and functional results. Surg Endosc 23, 577–582 (2009). https://doi.org/10.1007/s00464-008-9884-1
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DOI: https://doi.org/10.1007/s00464-008-9884-1