Quality of life after colorectal surgery: A prospective study of patients compared with their spouses

Although radical surgery for colorectal cancer improves the oncological outcomes, a significant portion of patients suffer from alterations in their quality of life (QoL). There are many studies investigating the QoL of patients who have colorectal cancer but none of these focus on the QoL of spouses.

To compare the QoL of patients after colorectal surgery to the QoL of spouses.

This prospective study consisted of patients who were married and who underwent surgery at the University of Ankara, Department of Surgery between March 2006 and November 2010. Patients' spouses were also enrolled. The study was approved by the Ethics Committee of the Faculty of Medicine, Ankara University, and all patients provided written informed consent. The study included patients who underwent curative surgery for colorectal carcinoma [n = 100; abdominoperineal excision (n = 33), low anterior resection (n = 33), left hemicolectomy (n = 34)] and their spouses (n = 100). The patients and spouses completed the Medical Outcome Study 36-item Short Form Survey (SF-36) and the World Health Organization Disability Assessment Schedule II (WHODAS-II) preoperatively and at postoperative months 15 to 18.

During this 4.5-year study period, 273 patients with sigmoid or rectal cancer were admitted to the hospital. Of these patients, 119 were eligible and willing to participate. Eleven patients had either systemic or locally inoperable disease, three patients had a severe surgical complication, and five patients were lost to follow-up. Therefore, a total of 100 patients completed the follow-up period. There was a statistically significant positive correlation between the disability scores of patients and the scores of their spouses for some of the WHODAS-II subscales, such as "self-care," "life activities," and "participation in society," as well as for the total WHODAS-II score. There was also a positive correlation between the QoL of patients and the QoL of their spouses in most of the SF-36 subscales. Statistically significant correlations were observed for the "bodily pain," "general health," "vitality," "social function," "emotion," "mental health," and mental component summary score subscales of the SF-36. When gender differences were evaluated, the QoL of male patients' spouses changed more when compared with female patients' spouses for all of the WHODAS-II subscales. Colorectal cancer surgery has a significant effect on the QoL of both patients and their spouses, these effects were more significant among male patients' spouses.

Preoperative counseling regarding potential problems should therefore collectively address patient and their spouse as a couple rather than the patient alone, particularly for patients undergoing low anterior resection and abdominoperineal resection procedures.