INTRODUCTION: The aim of this study was to compare the health-related quality of life (HRQoL) results of the open and laparoscopic approaches in patients who underwent a sphincter-preserving resection for rectal cancer.
METHODS: A total of 122 patients who underwent surgery for rectal cancer at a single center between January 2017 and December 2018 were included in this prospective study. The patients were divided into 2 groups according to the type of surgical procedure: open (n=85) or laparoscopy (n=37). The HRQoL questionnaires employed were the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal Cancer 29 (EORTC QLQ-CR29).
RESULTS: The EORTC QLQ-C30 questionnaire revealed statistically significant differences with better results in the laparoscopic group for the following items: global status (p=0.008), role functioning (p=0.003), and nausea/vomiting (p=0.005). A significant difference was seen on the EORTC QLQ-CR29 questionnaire only for the flatulence item, with a better score recorded in the laparoscopic group (p=0.02).
DISCUSSION AND CONCLUSION: The laparoscopic approach in rectal cancer surgery was superior to the open approach in terms of HRQoL in the early period. However, long-term results indicated that HRQoL was independent of surgical approach.
GİRİŞ ve AMAÇ: Rektal kanser nedeniyle sfinkter koruyucu rezeksiyon yapılan hastalarda açık ile laparoskopik yaklaşımın yaşam kalitesi sonuçlarını karşılaştırmayı amaçladık.
YÖNTEM ve GEREÇLER: Ocak 2017–Aralık 2018 tarihleri arasında kliniğimizde rektum kanseri nedeniyle ameliyat edilen 122 hasta çalışmaya alındı. Hastalar cerrahi tekniğe göre iki gruba ayrıldı; açık (n=85) ve laparoskopi (n=37). Yaşam kalitesi anketi, European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30) ve European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal Cancer 29 (EORTC QLQ-CR29) formlarını içermektedir.
BULGULAR: EORTC QLQ-C30 anketinde, genel durum (p=0.008), fiziksel aktivite (p=0.003) ve bulantı/kusma (p=0.005) öğelerinde laparoskopik grupta istatistiksel olarak anlamlı daha iyi sonuçlar elde edildi. EORTC QLQ-CR29 anketinde, sadece şişkinlik değerlendirmesinde laparoskopik grupta istatistiksel olarak anlamlı daha yüksek değerler saptandı (p=0.02).
TARTIŞMA ve SONUÇ: Rektal kanser cerrahisinde laparoskopik yaklaşım, erken dönemde yaşam kalitesi açısından açık yaklaşımdan üstündür. Bununla birlikte uzun dönem sonuçlarda cerrahi tekniğin yaşam kalitesini değiştirmediği saptandı.