71953 - Persistent sitting and walking difficulties after abdominoperineal excision - results from the QoLiRECT study
Lina Björklund Sand, Charlotta Larsson, Rode Grönkvist, Eva Haglind, Eva AngeneteAbstract
Introduction
The surgical resection options in rectal cancer are anterior resection for tumours in the mid or upper rectum and abdominoperineal excision for tumours in the lower rectum. One previous study has shown long-term persistent perineal symptoms after abdominoperineal excision. The aim of this study was to examine the prevalence and extent of chronic perineal and intergluteal symptoms after abdominoperineal excision compared to anterior resection. The primary objective was to compare frequency of difficulties sitting or walking between the two surgical procedures.
Method
Data was collected from the QoLiRECT study, an international, multicentre, observational, prospective, longitudinal study. Patients answered questionnaires about bodily functions, symptoms and quality of life at baseline and at 1 and 2 years after diagnosis.
Result
The study included 1024 patients. In the group of patients who underwent abdominoperineal excision 29 % had difficulties sitting after 2 years compared to 12 % in the group who underwent anterior resection. The adjusted odds ratio regarding sitting difficulties was 2.65 (CI 1.71-4.09, p<0.0001). Walking difficulties after 2 years were seen in 35 % after abdominoperineal excision compared to 24 % after anterior resection, adjusted odds ratio 1.50 (CI 1.02-2.22, p=0.04).
Discussion
Abdominoperineal excision for rectal cancer was associated with both walking and sitting difficulties at significantly higher rates compared to what was found after anterior resection. It is probable that attention from healthcare could improve the situation of the patients. Further interventional studies are under way.