@article{3160683,
    title = "Do Anastomotic Leaks Impair Postoperative Health-related Quality of Life
After Rectal Cancer Surgery? A Case-matched Study",
    author = "Marinatou, Annezo and Theodoropoulos, George E. and Karanika, Styliani and and Karantanos, Theodoros and Siakavellas, Spiridon and Spyropoulos, and Basileios G. and Toutouzas, Konstantinos and Zografos, George",
    journal = "Diseases of the Colon & Rectum",
    year = "2014",
    volume = "57",
    number = "2",
    pages = "158-166",
    publisher = "Lippincott, Williams & Wilkins",
    issn = "0012-3706, 1530-0358",
    doi = "10.1097/DCR.0000000000000040",
    keywords = "Colorectal cancer; Anastomotic leak; Health-related quality of life;
Medical Outcomes Study Short Form 36; Gastrointestinal Quality of life
Index; European Organization of Research and Treatment of Cancer Quality
of Life Questionnaire-C30",
    abstract = "BACKGROUND: Anastomotic leaks after colorectal resections for cancer are
a leading cause of postoperative morbidity, mortality, and long hospital
stay. Few data exist on the potentially deleterious effect of the
anastomotic leaks after proctectomy for cancer on patient health-related
quality of life.
OBJECTIVE: The aim of this study was to explore the effect of clinically
evident anastomotic leaks on health-related quality of life after rectal
cancer excision.
DESIGN: This is a case-matched study.
SETTINGS: This study was conducted in a Greek academic surgical
department.
PATIENTS: Included were 25 patients undergoing low anterior resection
complicated by an anastomotic leak (Clavien classification II, n = 14,
and III, n = 11) and 50 patients undergoing low anterior resection with
an uncomplicated course.
MAIN OUTCOME MEASURES: Health-related quality-of-life data were
prospectively collected at fixed assessment time points (baseline, 3, 6,
and 12 months postoperatively) by the use of validated questionnaires
(Medical Outcomes Study Short Form 36, Gastrointestinal Quality of Life
Index, European Organization of Research and Treatment of Cancer Quality
of Life Questionnaire-C30, and European Organization of Research and
Treatment of Cancer Quality of Life Questionnaire-CR29).
RESULTS: Leak patients required a longer hospitalization. Although the
numbers of initially constructed defunctioning loop ileostomies were not
significantly different between cases and controls, leak patients were
required to remain with a stoma significantly more often at all
postoperative assessment time points. No differences were observed in
the baseline scores between the 2 groups. Physical function of leak
patients was significantly worse at all postoperative assessment time
points. At 6 and 12 months, their emotional and social function and
overall quality-of-life scores were significantly decreased in
comparison with the patients with an uncomplicated course. Leak patients
experienced significantly more stoma-related problems and sore skin
around the stoma site.
LIMITATIONS: Limited number of patients, restriction of follow-up to the
end of the first year, and heterogeneity in terms of the presentation,
severity, and management of anastomotic leaks were the limitations of
this study.
CONCLUSIONS: Anastomotic leaks have an adverse effect on postoperative
health-related quality of life."
}