The studies included in this review do not allow firm conclusions as to the question of whether the quality of life of people after anterior resection is superior to that of people after abdominoperineal excision/Hartmann's operation. The included studies challenges the assumption that anterior resection patients fare better.Larger, better designed and executed prospective studies are needed to answer this question.
Objective assessment of morbidity and quality of life after surgery for low rectal cancer.
OBJECTIVE: To determine whether an anterior resection for low rectal cancer is associated with less morbidity and a better quality of life than an abdominoperineal resection. PATIENTS AND METHODS: Fifty-three patients who had anterior resection for low rectal cancer were individually matched with 53 other patients, who had an abdominoperineal resection during the same period of time, for gender, age and socioeconomic status. There was no evidence of tumour recurrence in these patients. All patients answered three quality of life questionnaires at least one year after surgery: Short Form 36 version 2, EORTC QLQ-C30 and EORTC QLQ-CR38. Details on short-term and long-term complications were collected prospectively. RESULTS: There was no significant difference in both the short-term and the long-term complication rates between the two groups of patients. There was also no difference in the global quality of life score on the QLQ-C30. However, patients who had an anterior resection had a better perception of body image than those who had an abdominoperineal resection, as measured on the QLQ-CR38 questionnaire (P=0.009), but were more prone to suffer from constipation (P=0.001). CONCLUSIONS: The overall similarities in quality of life between the two groups is probably a reflection of better stoma care, although problems with body image still persist in stoma patients.