Avaliação da qualidade de vida de pacientes em pós-operatório tardio de excisão total do mesorreto, para tratamento do câncer de reto

Abstract

With the advent of total mesorectal excision (TEM) and radiochemotherapy, excellent oncological results have been achieved in the treatment of patients with cancer of the rectum. Given this, it has been increasingly valued functional results of this type of therapeutic approach, as well as the factors that could impact them negatively and positively, directly affecting quality of life (QOL) of patients. The aims of this study were to evaluate the QOL of patients with rectal cancer underwent TEM in the late postoperative period and the possible factors that directly influence the quality of life for them. We evaluated seventy-two patients underwent TEM for extraperitoneal rectal tumor, with at least one year of surgery, by means of aplication of questionnaires of QOL (EORTC QLQ-C30 and EORTC QLQ-CR38) and specific clinical questionnaire. Then, they had undergone to proctological examination with assessment of distance of the anastomosis to the anal margin. Patients were evaluated with regard to gender, age, indication of radiotherapy and chemotherapy preoperatively, length of postoperative period, distance of anastomosis to the anal margin and general health. The average overall health status of patients was satisfactory (82.06). There was no difference in overall health between patients with respect to gender, but the male patients had less insomnia (p=0.002), better future prospects (p=0.011), less effects of chemotherapy (p=0.020) and better sexual function (p<0.0001). Patients younger than 50 years had fewer urinary problems (p = 0.035), as those over 65 years reported poorer sexual function (p=0.012). Patients who underwent neoadjuvant therapy had more diarrhea (p=0.012). Quality of life did not change significantly with time after surgery and the distance of the anastomosis to the anal margin. We conclude that patients undergoing ETM have a good quality of life after one year of surgery and that the factors involved should be identified and optimized.