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Chirurgie 1. Juni 2012

Objective measurable anoneorectal function poorly correlates with the overall quality of life after mesorectal excision for rectal cancer

BACKGROUND: Health related quality of life and functional disturbances of the neorectum are increasingly gaining in importance. METHODS: 48 patients after mesorectal excision were examined in a retrospective cohort study by anorectal manometry and pelvic floor surface electromyography. HRQoL was assessed by the SF-36 and the EORTC QLQ 30 questionnaire. Sexual and urogenital functions were examined by the IIEF and IPSS questionnaire. RESULTS: Mean resting-/squeeze-pressure was almost normal at 59.8±18.9 mm Hg/132.1±16.2 mm Hg. Perception- and defecation level were at 49.4±21 ml and at 100.9±44.3 ml. Average and maximal amplitude of the pelvic floor EMG was 9.5±2 µV and 14.2±2.6 µV. Mild positive correlation was given between minimal resting pressure and nausea/social function r = 0.495/r = 0.344. Maximal amplitude significantly correlated with physical function (r = 0.386). The SF-36 data were compared to the standardized control sample of n = 2914 German subjects. For both IIEF (23.8±20.7) and IPSS (irritative: 3.6±3.3/obstruction 2.8±4.2), we found markedly reduced function scores but high inter-individual variations. CONCLUSIONS: The link between measurable anorectal function and HRQoL is poor after mesorectal excision. Anoneorectal function after one year is not an exclusive factor having an impact on HRQoL.

J. Schuld, M. R. Moussavian, O. Kollmar, C. A. Maurer, S. Richter, M. K. Schilling, European Surgery 3/2012

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