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.