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Long-Term Functional and Quality of Life Outcomes After Coloanal Anastomosis for Distal Rectal Cancer

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Diseases of the Colon & Rectum

Purpose

This study was designed to evaluate the long-term functional and quality-of-life outcomes of patients after coloanal anastomosis for distal rectal cancer.

Methods

A total of 192 patients underwent coloanal anastomosis between 1982 and 2001 at two tertiary referral institutions. Standardized and validated questionnaires to assess functional and quality-of-life outcomes were mailed to 151 patients, of which 121 patients responded (median follow-up, 65 months).

Results

Patients receiving pelvic radiotherapy had more bowel function problems than patients who did not receive pelvic radiotherapy. No significant differences in relevant functional and quality-of-life outcomes were seen among patients who received preoperative or postoperative pelvic radiotherapy. Patients requiring permanent diversion as a result of complications of the surgery had decreased quality of life.

Conclusions

Coloanal anastomosis for distal rectal cancer has favorable long-term outcomes. Pelvic radiotherapy has an adverse effect on subsequent bowel function (whether given preoperatively or postoperatively) in patients who maintain intestinal continuity. Loss of intestinal continuity after a coloanal anastomosis is associated with diminished quality of life.

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Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA

    Imran Hassan M.D., David W. Larson M.D., Robert R. Cima M.D., Janette U. Gaw M.D., Dieter Hahnloser M.D., John M. Stulak M.D., Bruce G. Wolff M.D. & John H. Pemberton M.D.

  2. Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, Florida, USA

    Heidi K. Chua M.D.

  3. Division of Biostatistics, Mayo Clinic, Rochester, Minnesota, USA

    Megan M. O’Byrne M.A. & Dirk R. Larson M.S.

  4. Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA

    David W. Larson M.D.

Authors
  1. Imran Hassan M.D.
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  2. David W. Larson M.D.
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  3. Robert R. Cima M.D.
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  4. Janette U. Gaw M.D.
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  5. Heidi K. Chua M.D.
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  6. Dieter Hahnloser M.D.
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  7. John M. Stulak M.D.
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  8. Megan M. O’Byrne M.A.
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  9. Dirk R. Larson M.S.
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  10. Bruce G. Wolff M.D.
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  11. John H. Pemberton M.D.
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Corresponding author

Correspondence to David W. Larson M.D..

Additional information

Read in part at the meeting of The American Society of Colon and Rectal Surgeons, Philadelphia, Pennsylvania, April 30 to May 5, 2005.

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Hassan, I., Larson, D.W., Cima, R.R. et al. Long-Term Functional and Quality of Life Outcomes After Coloanal Anastomosis for Distal Rectal Cancer. Dis Colon Rectum 49, 1266–1274 (2006). https://doi.org/10.1007/s10350-006-0640-0

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  • DOI: https://doi.org/10.1007/s10350-006-0640-0

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