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Evidence summaries

Quality of Life after Rectal Resection for Cancer

There is no unequivocal evidence that the quality of life after sphincter-preserving anterior resection for rectal cancer would be superior as compared to abdominoperineal excision with colostomy. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 26 non-randomised studies with a total of 3 675 subjects. Ten trials found that people with rectal cancer undergoing traditional abdominoperineal excision/Hartmann's operation with a colostomy did not have poorer quality of life measures than patients undergoing sphincter-preserving anterior resection. The rest of the studies found some difference, but not always in favour of non-stoma patients. Due to clinical heterogeneity and the fact that all studies were observational trials, meta-analysis of the included studies was not possible.

Comment: The quality of evidence is downgraded by inconsistency (variability in results across studies).

    References

    • Pachler J, Wille-Jørgensen P. Quality of life after rectal resection for cancer, with or without permanent colostomy. Cochrane Database Syst Rev 2005;(2):CD004323 [Review content assessed as up-to-date: 22 February 2010]. [PubMed]

Primary/Secondary Keywords