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dc.contributor.authorLawday, S.
dc.contributor.authorFlamey, N.
dc.contributor.authorFowler, G. E.
dc.contributor.authorLeaning, M.
dc.contributor.authorDyar, N.
dc.contributor.authorDaniels, I. R.
dc.contributor.authorSmart, N. J.
dc.contributor.authorHyde, C.
dc.date.accessioned2022-02-28T14:50:13Z
dc.date.available2022-02-28T14:50:13Z
dc.date.issued2021-11-09
dc.identifier.citationBJS Open. 2021 Nov 9;5(6):zrab101. doi: 10.1093/bjsopen/zrab101.
dc.identifier.pmid35040944
dc.identifier.doi10.1093/bjsopen/zrab101
dc.identifier.urihttps://rde.dspace-express.com/handle/11287/622369
dc.description.abstractBACKGROUND: Low rectal cancers could be treated using restorative (anterior resection, AR) or non-restorative procedures with an end/permanent stoma (Hartmann's, HE; or abdominoperineal excision, APE). Although the surgical choice is determined by tumour and patient factors, quality of life (QoL) will also influence the patient's future beyond cancer. This systematic review of the literature compared postoperative QoL between the restorative and non-restorative techniques using validated measurement tools. METHODS: The review was registered on PROSPERO (CRD42020131492). Embase and MEDLINE, along with grey literature and trials websites, were searched comprehensively for papers published since 2012. Inclusion criteria were original research in an adult population with rectal cancer that reported QoL using a validated tool, including the European Organization for Research and Treatment of Cancer QLQ-CR30, QLQ-CR29, and QLQ-CR38. Studies were included if they compared AR with APE (or HE), independent of study design. Risk of bias was assessed using the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool. Outcomes of interest were: QoL, pain, gastrointestinal (GI) symptoms (stool frequency, flatulence, diarrhoea and constipation), and body image. RESULTS: Nineteen studies met the inclusion criteria with a total of 6453 patients; all papers were observational and just four included preoperative evaluations. There was no identifiable difference in global QoL and pain between the two surgical techniques. Reported results regarding GI symptoms and body image documented similar findings. The ROBINS-I tool highlighted a significant risk of bias across the studies. CONCLUSION: Currently, it is not possible to draw a firm conclusion on postoperative QoL, pain, GI symptoms, and body image following restorative or non-restorative surgery. The included studies were generally of poor quality, lacked preoperative evaluations, and showed considerable bias in the data.
dc.language.isoeng
dc.publisherWiley
dc.relation.urlhttps://academic.oup.com/bjsopen/article-lookup/doi/10.1093/bjsopen/zrab101
dc.rights© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.
dc.titleQuality of life in restorative versus non-restorative resections for rectal cancer: systematic review
dc.typeJournal Article
dc.identifier.journalBJS open
dc.identifier.pmcidPMC8765336
dc.description.noteThe article is available via Open Access. Click on the 'Additional link' above to access the full-text.
dc.type.versionppublish
dc.description.admin-notePublished version, accepted version, submitted version
dc.date.epub2022-01-19
dc.citation.volume5
dc.citation.issue6


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