DOES THE LEVEL OF ANASTOMOSIS EFFECT THE QUALITY OF LIFE AFTER SPHINCTER SAVING RESECTION FOR LOW RECTAL CARCINOMA?
AYHAN KUZU, W G LEWİS, D JONES, P J HOLDSWORTH, P J FINAN, D JOHNSTON
The General Infirmary, Leeds Üniversitesi, Genel Cerrahi Bölümü, Leeds, İNGİLTERE
In order to assess the quality of life for patients with carcinoma of the lower two-thirds of the rectum, a detailed questionnaire and the Hospital Anxiety and Depression test were administered to a consecutive 41 patients who had been treated by curative low anterior resection, further divided into 3 subgroups according to the level of anastomosis by sigmoidoscopy and anorectal manometry. As a control group, 28 patients who had been treated by abdomino-perineal resection have also been assessed with the same questionnaire. The median bowel frequency, the degree of urgency of defecation, the number of patients with faecal leakage were greater after colo-anal and very low colo-rectal anastomosis than after colo-rectal anastomosis. Nevertheless, patients with very low resections are still content with the outcome. We conclude that, quality of life is related to the amount of residual rectum after sphincter saving resection and getting worse when the level of anastomosis close to anal verge.