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Quality of life in colorectal cancer

Stoma vs. nonstoma patients

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: The bowel and sexual function of colorectal cancer patients undergoing either sphincter-saving or sphincter-sacrificing surgical procedures may be impaired. A legitimate question is how these different surgical techniques affect the patients' quality of life. METHODS: Seventeen studies were identified that compared at least one of four aspects of patient functioning (i.e.,physical, psychologic, social, and sexual) between stoma patients and non-stoma patients. RESULTS: Although the literature does not yield entirely consistent findings, some long-term effects of surgery can be identified: 1) both patient groups are troubled by frequent or irregular bowel movements and diarrhea; 2) stoma patients report higher levels of psychologic distress than do nonstoma patients; 3) although both stoma patients and nonstoma patients report restrictions in their level of social functioning, such problems are more prevalent among patients with a colostomy; 4) sexual functioning of male and female stoma patients is consistently more impaired than that of male and female patients with intact sphincters. Results of the current review were compared with those of other, related areas. CONCLUSIONS: Although nonstoma patients generally fare better than do stoma patients, they also suffer from physical impairments induced by sphincter-saving procedures (e.g.,impaired bowel and sexual function). These impairments may become more prevalent as ultralow anastomosis is more frequently applied, resulting in bowel and sexual dysfunction and related psychologic distress. Well-designed studies are needed that examine whether quality-of-life benefits are to be gained by use of ultralow anastomosis compared with colostomy.

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Authors and Affiliations

  1. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX Amsterdam, The Netherlands

    M. A. G. Sprangers Ph.D., N. K. Aaronson Ph.D. & A. te Velde M.Sc

  2. Department of Gastroenterology, The Netherlands Cancer Institute, The Netherlands

    B. G. Taal M.D., Ph.D.

  3. Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands

    N. K. Aaronson Ph.D.

Authors
  1. M. A. G. Sprangers Ph.D.
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  2. B. G. Taal M.D., Ph.D.
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  3. N. K. Aaronson Ph.D.
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  4. A. te Velde M.Sc
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Additional information

Supported in part by a grant from the Dutch Cancer Society, Amsterdam, The Netherlands (Project NKI 90-A).

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Sprangers, M.A.G., Taal, B.G., Aaronson, N.K. et al. Quality of life in colorectal cancer. Dis Colon Rectum 38, 361–369 (1995). https://doi.org/10.1007/BF02054222

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