Long-term Functional Outcome After Right-Sided Complete Mesocolic Excision Compared With Conventional Colon Cancer Surgery: A Population-Based Questionnaire Study

Autor: Bent Kristensen, Katrine J Emmertsen, Helene M Larsen, Anders Ulrich Neuenschwander, Claus Anders Bertelsen, Søren Laurberg
Rok vydání: 2018
Předmět:
Diarrhea
Male
medicine.medical_specialty
Databases
Factual
Colon
Colorectal cancer
Chronic Pain/etiology
Population based
Adenocarcinoma
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Quality of life
Colon surgery
Surveys and Questionnaires
Colon/pathology
medicine
Mesocolon/pathology
Humans
Colectomy
Aged
Retrospective Studies
Questionnaire study
Adenocarcinoma/pathology
business.industry
Colonic Neoplasms/surgery
Gastroenterology
Retrospective cohort study
General Medicine
Middle Aged
medicine.disease
digestive system diseases
Surgery
Bowel dysfunction
Treatment Outcome
Increased risk
030220 oncology & carcinogenesis
Colonic Neoplasms
Quality of Life
Diarrhea/etiology
Female
030211 gastroenterology & hepatology
Colectomy/adverse effects
Chronic Pain
business
Mesocolon
Zdroj: Bertelsen, C A, Larsen, H M, Neuenschwander, A U, Laurberg, S, Kristensen, B & Emmertsen, K J 2018, ' Long-term Functional Outcome After Right-Sided Complete Mesocolic Excision Compared With Conventional Colon Cancer Surgery: A Population-Based Questionnaire Study ', Diseases of the Colon and Rectum, vol. 61, no. 9, pp. 1063-1072 . https://doi.org/10.1097/DCR.0000000000001154
ISSN: 0012-3706
Popis: BACKGROUND: Complete mesocolic excision improves the long-term outcome of colon cancer but might carry a risk of bowel dysfunction.OBJECTIVE: This study aimed to investigate whether right-sided complete mesocolic excision is associated with an increased risk of long-term bowel dysfunction and reduced quality of life compared with conventional colon cancer resections.DESIGN: Data were extracted from a population-based study comparing complete mesocolic excision and conventional colon cancer resections and from a national questionnaire survey regarding functional outcome.SETTINGS: Elective right-sided colon resections for stage I to III colon adenocarcinoma were performed at 4 university colorectal centers between June 2008 and December 2014.PATIENTS: Seven hundred sixty-two patients were eligible to receive the questionnaire in November 2015.MAIN OUTCOME MEASURES: The primary outcomes measured were the risk of diarrhea (Bristol stool scale score of 6-7), 4 or more bowel movements daily, and the impact of bowel function on quality of life. Secondary outcomes were other bowel symptoms, chronic pain, and quality of life measured by the European Organisation for Research and Treatment of Cancer QLQ-C30.RESULTS: One hundred forty-one (63.8%) and 324 (59.9%) patients undergoing complete mesocolic excision and conventional resections responded after a median of 3.99 (interquartile range, 2.11-5.32) and 4.11 (interquartile range, 3.01-5.53) years (p = 0.04). Complete mesocolic excision was not associated with increased risk of diarrhea (adjusted OR, 1.07; 95% CI, 0.57-1.95; p = 0.84), 4 or more bowel movements daily (adjusted OR, 1.16; 95% CI, 0.57-2.24; p = 0.68), or lower quality of life (adjusted OR, 0.84; 95% CI, 0.49-1.40; p = 0.50). Complete mesocolic excision was associated nonsignificantly with nocturnal bowel movements, but not associated with chronic pain or other secondary outcomes.LIMITATIONS: This study was limited by the retrospective design with unknown baseline symptoms. Responding patients were younger but without obvious selection bias. The outcome "diarrhea" seemed somehow sensitive to information bias.CONCLUSION: Right-sided complete mesocolic excision seems associated with neither bowel dysfunction nor impaired quality of life when compared with conventional surgery. See Video Abstract at http://links.lww.com/DCR/A665.
Databáze: OpenAIRE
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