Skip to main content
SpringerLink
Log in

Quality of Life after Low Anterior Resection and Temporary Loop Ileostomy

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

Abstract

Purpose

Low anterior resection has become the operation of choice for mid rectal or low rectal cancer. A defunctioning stoma is routinely created at some centers to decrease the risk of leakage requiring surgical intervention. This study was designed to evaluate the quality of life in patients undergoing low anterior resection with a temporary ileostomy.

Methods

A prospective longitudinal study was conducted in 22 patients with rectal cancer who underwent low anterior resection with a loop ileostomy. Quality of life was assessed by using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR38 questionnaires. Twenty-five patients who underwent high anterior resection for rectosigmoid cancer were studied concurrently to evaluate the impact of major colorectal resection without a stoma.

Results

Patients’ scores on the quality of life questionnaires generally improved after high anterior resection; however, for patients who underwent low anterior resection, the scores for physical and role functioning before ileostomy closure were worse than the preoperative values. The scores on the quality of life questionnaires generally improved after ileostomy closure. Ileostomy closure required a short hospital stay and was rarely associated with complications.

Conclusion

Patients who underwent low anterior resection with ileostomy had significant reductions in physical and role functioning, which apparently improved after ileostomy closure. Similar declines in these quality of life variables were not found in patients who underwent high anterior resection. A temporary ileostomy should be created in selected patients with the highest risk of anastomotic leakage. Increased resources for not only surgical care but also for stoma therapy are necessary for patients who undergo low anterior resection with a temporary ileostomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Heald RJ. Total mesorectal excision is optimal surgery for rectal cancer: a Scandinavian consensus. Br J Surg 1995;82:1297–9.

    Article  PubMed  CAS  Google Scholar 

  2. Nicholls RJ, Hall C. Treatment of non-disseminated cancer of the lower rectum. Br J Surg 1996;83:15–8.

    Article  PubMed  CAS  Google Scholar 

  3. Karanjia ND, Cordon AP, Holdsworth PL, Heald RJ. Risk of peritonitis and fatal septicaemia and the need to defunction the low anastomosis. Br J Surg 1991;78:196–8.

    Article  PubMed  CAS  Google Scholar 

  4. Arbman G, Nilsson, Hallbook O, Sjodahl R. Local recurrence following total mesorectal excision for rectal cancer. Br J Surg 1996;83:375–9.

    Article  PubMed  CAS  Google Scholar 

  5. Grabham JA, Moran BJ, Lane RH. Defunctioning colostomy for low anterior resection: a selective approach. Br J Surg 1995;82:1331–2.

    Article  PubMed  CAS  Google Scholar 

  6. Poon RT, Chu KW, HO JW, Chan CW, Law WL, Wong J. Prospective evaluation of selective defunctioning stoma for low anterior resection with total mesorectal excision. World J Surg 1999;23:463–7.

    Article  PubMed  CAS  Google Scholar 

  7. Marusch F, Koch A, Schmidt U, et al. Value of a protective stoma in low anterior resection for rectal cancer. Dis Colon Rectum 2002;45:1164–71.

    Article  PubMed  Google Scholar 

  8. Getinger I, Marusch F, Steinert R, et al. Prospective defunctioning stoma in low anterior resection for rectal carcinoma. Br J Surg 2005;92:1137–42.

    Article  Google Scholar 

  9. O’Leary DP, Fide CJ, Foy C, Lucarotti ME. Quality of life after low anterior resection with total mesorectal excision and temporary loop ileostomy for rectal carcinoma. Br J Surg 2001;88:1216–20.

    Article  PubMed  CAS  Google Scholar 

  10. Camilleri-Brennan J, Steele RJ. Prospective analysis of quality of life after reversal of a defunctioning loop ileostomy. Colorectal Dis 2002;4:167–71.

    Article  PubMed  Google Scholar 

  11. Aaronson NK, Ahmedzai S, Bergman B, et al. European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993;85:365–76.

    Article  PubMed  CAS  Google Scholar 

  12. Sprangers MA, te Velde A, Aaronson NK. The construction and testing of the EORTC Colorectal Cancer-specific quality of life questionnaire module (QLQ-CR38). Eur J Cancer 1999;35:238–47.

    Article  PubMed  CAS  Google Scholar 

  13. Kobayashi K, Takeda F, Teramukai S, et al. A cross-validation of the European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30) for Japanese with lung cancer. Eur J Cancer 1998;34:810–5.

    Article  PubMed  CAS  Google Scholar 

  14. Tsunoda A, Yasuda N, Nakao K, et al. The construction and testing of the Japanese vergion of EORTC colorectal cancer-specific quality of life questionnaire module (EORTC QLQ-CR38) [in Japanese]. J Jpn Soc Coloproctol 2007;60:69–76.

    Article  Google Scholar 

  15. EORTC Study Group on Quality of Life 1995. EortC QLQ-C30 scoring manual. Brussels: EORTC, 1995.

    Google Scholar 

  16. Tsunoda A, Nakao K, Hiratsuka K, Tsunoda Y, Kusano M. Prospective analysis of quality of life in the first year after colorectal cancer surgery. Acta Oncologica 2007;46:77–82.

    Article  PubMed  Google Scholar 

  17. Osoba D, Rodrigues G, Myles J, Zee B, Pater J. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 1998;16:139–44.

    PubMed  CAS  Google Scholar 

  18. Dehni N, Schlegel RD, Cunningham C, Guiguet M, Tiret E, Parte R. Influence of a defunctioning stoma on leakage rates after low colorectal anastomosis and colonic J pouch-anal anastomosis. Br J Surg 1998;85:1114–7.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan

    Akira Tsunoda M.D., Ph.D., Yuko Tsunoda M.D., Ph.D., Kazuhiro Narita M.D., Ph.D., Makoto Watanabe M.D., Ph.D., Kentaro Nakao M.D., Ph.D. & Mitsuo Kusano M.D., Ph.D.

Authors
  1. Akira Tsunoda M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuko Tsunoda M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kazuhiro Narita M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Makoto Watanabe M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kentaro Nakao M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mitsuo Kusano M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akira Tsunoda M.D., Ph.D..

About this article

Cite this article

Tsunoda, A., Tsunoda, Y., Narita, K. et al. Quality of Life after Low Anterior Resection and Temporary Loop Ileostomy. Dis Colon Rectum 51, 218–222 (2008). https://doi.org/10.1007/s10350-007-9101-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-007-9101-7

Key words

Search

Navigation