Functional and quality of life outcomes among patients with lower rectal cancer treated with intersphincter surgery with and without antegrade continence enema with appendicostomy

Introduction: The gas and fecal incontinency are the main morbidities of intersphincteric surgical resection in the very low rectal cancer that could have negative outcomes in long-term for patients. The most important of them was psychological effects , such as Anxiety about fecal and gas incontinency. Various methods have been proposed for these patients, from these methods, appendicostomy is the most important. In this study we aimed to comparison of the functional and quality of life results in patients with low rectal cancer who underwent into Intersphincteric resection with or without Appendicostomy. Also we decided to examine effect of Placement Appendicostomy procedure on the Regulation Disposal Control, quality of life and functional outcome in these patients. Materials and Methods: This randomized, Non-blind, parallel ,clinical trial was performed during two year from December 2016 to October 2018 in Imam Khomeini Hospital (Sari, Iran), affiliated to Mazandaran University of Medical Sciences. The inclusion criteria was as follows: Stage 1( T1 ,T2 involve till mascularis properia) of very low rectal cancer which approved by an endosonography survey and pathologist faculty member based on World Health Organization criteria, those who had neoadjuant chemoradiotherapy. The Patients were evaluated for the incidence of abdominal and perineal surgical site infections and hospitalization time during post-op admission. After discharge, the EORTC QLQ-C30 score questionnaire, adjusted and approved by the European Organization for Research and Treatment of Cancer Quality of Life at 12 months post surgery, was monitored for quality of life. The WEXNER standard questionnaire was also used to evaluate continency control and functional outcomes. Results: 50 patients were enrolled and finally 30 patients finished the study. The average age of all patients was 56.23 years. It is more evident in the area of social and emotional problems in both groups. Performance , Cognitive, fatigue, weakness, vomiting between the two groups were not statistically significant (P> 0.05). There was a significant difference between the two groups in overall quality of life and defecation and controlled disposal. (P <0.05) Conclusion: Patients who underwent intersphincteric with appendicostomy surgery had a better defecation condition, controlled disposal, nausea and quality of life than patients without appendicostomy, and so, this procedure could use for all patients with colorectal cancer with intersphincteric surgery.

کلیدواژه ها:

Appendicostomy ، intersphincteric surgery ، quality of life