Quality of life after transperineal rectosigmoidectomy

Abstract

Abstract Background This study evaluated continence, constipation and quality of life before and after perineal rectosigmoidectomy for full-thickness rectal prolapse. Methods Consecutive patients with full-thickness rectal prolapse undergoing perineal rectosigmoid- ectomy (Altemeier's procedure) between May 2004 and June 2008 were studied. A standardized questionnaire, including the Cleveland Clinic Constipation Score (CCCS), Cleveland Clinic Incontinence Score (CCIS) and quality of life scores (EuroQol—Five Dimensions, EuroQol—Visual Analogue Scale and Patient Assessment of Constipation—Quality of Life (PAC-QOL)), was administered before and after operation. Results Thirty-eight patients (32 women) of mean(s.d.) age 75(13) years underwent rectosigmoid- ectomy. Seven patients developed postoperative complications and one died. There was one recurrence 5 months after surgery. Twenty-nine patients completed the follow-up questionnaire and were reviewed after a median of 24 (range 6–48) months. Constipation and incontinence were significantly improved after surgery (mean CCCS from 10·21 to 3·58 and CCIS from 14·17 to 11·42; P < 0·001). Quality of life, in terms of mobility, usual activities, pain/discomfort and anxiety/depression, were significantly better at follow-up (P < 0·001), as was subjective health status (P < 0·001). The PAC-QOL score improved significantly in all dimensions (P < 0·001). Conclusion Transperineal rectosigmoidectomy improves general and constipation-related quality of life with good functional results.