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).
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