Quality of life outcomes following laparoscopic total mesorectal excision for low rectal cancers: a clinical control study.

AIMS: To evaluate the health-related quality of life (HRQoL) outcomes in patients undergoing laparoscopic total mesorectal excision (LTME) with anal sphincter preservation (ASP) for low rectal cancers.

METHODS: Patients undergoing LTME with ASP or open procedures (OTME) for low rectal cancers were prospectively followed up. All patients were treated in curative attempt and were free of local recurrence during the study. HRQoL was assessed by questionnaires during 3-6 months, 12-18 months, and 2-5 years after surgery.

RESULTS: From June 2001 to March 2006, 125 patients undergoing LTME and 103 undergoing OTME were included in this study. In contrast to OTME patients, the LTME ones showed significantly better physical function during 3-6 months after surgery, less micturition problems within 12-18 months, less male sexual problems and better sexual function during 12-18 months after surgery, with better sexual enjoyment after 24 months postoperatively. Both groups showed significant improvement in most subscales from the first to the second assessment, and an improvement in sexual enjoyment from the second to the third assessment. The sexual function, micturition problems and male sexual problems in the LTME group significantly improved from the first to the second assessment, whereas the sexual function in the OTME group improved from the second to the third assessment.

CONCLUSIONS: Patients undergoing LTME for low rectal cancers can achieve superior postoperative HRQoL than patients undergoing OTME, with superior physical function, micturition function, overall sexual and male sexual functions in the short term, and better sexual enjoyment in the long term. The HRQoL of both LTME and OTME patients may be expected to improve over time, particularly over the first postoperative year.