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Quality of life after transperineal rectosigmoidectomy
M Kim1, J Reibetanz, L Boenicke
1Department of General, Gastrointestinal, Vascular and Paediatric Surgery, University Hospital Wuerzburg, Wuerzburg, Germany. kim_m@chirurgie.uni-wuerzburg.de
Background:
: This study evaluated continence, constipation and quality of life before and after perineal rectosigmoidectomy for full-thickness rectal prolapse.
Methods:
: Consecutive patients with full-thickness rectal prolapse undergoing perineal rectosigmoid- ectomy (Altemeier's procedure) between May 2004 and June 2008 were studied. A standardized questionnaire, including the Cleveland Clinic Constipation Score (CCCS), Cleveland Clinic Incontinence Score (CCIS) and quality of life scores (EuroQol-Five Dimensions, EuroQol-Visual Analogue Scale and Patient Assessment of Constipation-Quality of Life (PAC-QOL)), was administered before and after operation.
Results:
: Thirty-eight patients (32 women) of mean(s.d.) age 75(13) years underwent rectosigmoid- ectomy. Seven patients developed postoperative complications and one died. There was one recurrence 5 months after surgery. Twenty-nine patients completed the follow-up questionnaire and were reviewed after a median of 24 (range 6-48) months. Constipation and incontinence were significantly improved after surgery (mean CCCS from 10.21 to 3.58 and CCIS from 14.17 to 11.42; P < 0.001). Quality of life, in terms of mobility, usual activities, pain/discomfort and anxiety/depression, were significantly better at follow-up (P < 0.001), as was subjective health status (P < 0.001). The PAC-QOL score improved significantly in all dimensions (P < 0.001).
Conclusion:
: Transperineal rectosigmoidectomy improves general and constipation-related quality of life with good functional results.
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