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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 6/2017

Open Access 01-06-2017 | Original Article

A prospective case control study of functional outcomes and related quality of life after colectomy for neoplasia

Authors: Adela Brigic, Samia Sakuma, Richard E. Lovegrove, Paul Bassett, Omar Faiz, Susan K. Clark, Neil Mortensen, Robin H. Kennedy

Published in: International Journal of Colorectal Disease | Issue 6/2017

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Abstract

Aim

Our aim was to assess bowel function and its effect on overall quality of life (QOL) when compared to healthy controls after colectomy.

Methods

Patients undergoing resection of colorectal neoplasia were recruited pre-operatively and followed up at 6 and 12 months, to assess ‘early’ bowel function. Patients who underwent surgery 2 to 4 years previously were recruited for assessment of ‘intermediate’ bowel function. Healthy relatives were recruited as controls. The Memorial Sloan-Kettering Cancer Centre and EQ-5D questionnaires were used to assess bowel function and QOL, respectively. Statistical assessment included regression analyses, parametric and non-parametric tests. The association between QOL and Memorial Sloan-Kettering Cancer Centre (MSKCC) scores was evaluated using Spearman’s rank correlation.

Results

Ninety-one patients were recruited for assessment of ‘early’ and 85 for ‘intermediate’ bowel function. There were 85 controls. Patients had a significantly higher number of bowel movements at each follow-up (p < 0.001). At 12 months after surgery, patients reported difficulty with gas-stool discrimination. The ‘intermediate’ group were found to have lower scores for flatus control (<0.001) and total frequency score (p 0.03), indicating worse function. Patients with higher total MSKCC scores, no symptoms of urgency and those able to control flatus reported better QOL (p 0.006, 0.007 and 0.005, respectively) at 6 and 12 months. Gas-stool differentiation and complete evacuation correlated with better QOL in the ‘intermediate’ bowel function group (p 0.02 and 0.02, respectively).

Conclusion

Colonic resection adversely affects elements of bowel function up to 4 years after surgery. Good colonic function, represented by higher MSKCC scores, correlates with better QOL.
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Metadata
Title
A prospective case control study of functional outcomes and related quality of life after colectomy for neoplasia
Authors
Adela Brigic
Samia Sakuma
Richard E. Lovegrove
Paul Bassett
Omar Faiz
Susan K. Clark
Neil Mortensen
Robin H. Kennedy
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 6/2017
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-016-2714-3

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