Prospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2021; 13(9): 1050-1062
Published online Sep 27, 2021. doi: 10.4240/wjgs.v13.i9.1050
Quality of life after colorectal surgery: A prospective study of patients compared with their spouses
Gökçe Aylaz, Cihangir Akyol, Akın Fırat Kocaay, Derya Gökmen, Ayşe Burcu Yavuzarslan, Ayhan Bülent Erkek, Mehmet Ayhan Kuzu
Gökçe Aylaz, Department of Surgery, Sisli Memorial Hospital, Istanbul 34385, Turkey
Cihangir Akyol, Akın Fırat Kocaay, Ayşe Burcu Yavuzarslan, Ayhan Bülent Erkek, Mehmet Ayhan Kuzu, Department of Surgery, Ankara University School of Medicine, Ankara 06100, Turkey
Derya Gökmen, Department of Biostatistics, Ankara University School of Medicine, Ankara 06100, Turkey
Author contributions: Aylaz G, Akyol C and Kuzu MA contributed to the study conception and design; Aylaz G, Kocaay AF, Yavuzarslan AB and Erkek AB contributed to the literature search and data extraction; Aylaz G, Gökmen D and Kuzu MA contributed to the acquisition, management, analysis and interpretation of data; Aylaz G, Kocaay AF and Akyol C drafted the manuscript; Kuzu MA and Akyol C critically revised the manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of the Faculty of Medicine, Ankara University (21 September 2009, approval number: 06-82).
Clinical trial registration statement: This study is registered at ClinicalTrials.gov. The registration identification number is NCT04744792.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None of the authors have a conflict of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cihangir Akyol, FASCRS, FEBS, MD, Professor, Department of Surgery, Divison of Colorectal Surgery, Ankara University School of Medicine, Ankara 06100, Turkey. cihangirakyol@gmail.com
Received: March 25, 2021
Peer-review started: March 25, 2021
First decision: June 14, 2021
Revised: June 30, 2021
Accepted: July 29, 2021
Article in press: July 29, 2021
Published online: September 27, 2021
Processing time: 177 Days and 0.9 Hours
Abstract
BACKGROUND

Although radical surgery for colorectal cancer improves the oncological outcomes, a significant portion of patients suffer from alterations in their quality of life (QoL). There are many studies investigating the QoL of patients who have colorectal cancer but none of these focus on the QoL of spouses.

AIM

To compare the QoL of patients after colorectal surgery to the QoL of spouses.

METHODS

This prospective study consisted of patients who were married and who underwent surgery at the University of Ankara, Department of Surgery between March 2006 and November 2010. Patients’ spouses were also enrolled. The study was approved by the Ethics Committee of the Faculty of Medicine, Ankara University, and all patients provided written informed consent. The study included patients who underwent curative surgery for colorectal carcinoma [n = 100; abdominoperineal excision (n = 33), low anterior resection (n = 33), left hemicolectomy (n = 34)] and their spouses (n = 100). The patients and spouses completed the Medical Outcome Study 36-item Short Form Survey (SF-36) and the World Health Organization Disability Assessment Schedule II (WHODAS-II) preoperatively and at postoperative months 15 to 18.

RESULTS

During this 4.5-year study period, 273 patients with sigmoid or rectal cancer were admitted to the hospital. Of these patients, 119 were eligible and willing to participate. Eleven patients had either systemic or locally inoperable disease, three patients had a severe surgical complication, and five patients were lost to follow-up. Therefore, a total of 100 patients completed the follow-up period. There was a statistically significant positive correlation between the disability scores of patients and the scores of their spouses for some of the WHODAS-II subscales, such as “self-care,” “life activities,” and “participation in society,” as well as for the total WHODAS-II score. There was also a positive correlation between the QoL of patients and the QoL of their spouses in most of the SF-36 subscales. Statistically significant correlations were observed for the “bodily pain,” “general health,” ”vitality,” “social function,” “emotion,” “mental health,” and mental component summary score subscales of the SF-36. When gender differences were evaluated, the QoL of male patients’ spouses changed more when compared with female patients’ spouses for all of the WHODAS-II subscales. Colorectal cancer surgery has a significant effect on the QoL of both patients and their spouses, these effects were more significant among male patients’ spouses.

CONCLUSION

Preoperative counseling regarding potential problems should therefore collectively address patient and their spouse as a couple rather than the patient alone, particularly for patients undergoing low anterior resection and abdominoperineal resection procedures.

Keywords: Quality of life; Colorectal surgery; Patients' spouses; Prospective study; Male spouses; Preoperative counseling

Core Tip: Although radical surgery for colorectal cancer improves the oncological outcomes, a significant portion of patients suffer from alterations in their quality of life (QoL). There are many studies investigating the QoL of patients who have colorectal cancer but none of these focus on the QoL of spouses. To the best of our knowledge, this is the first prospective and comparative study investigating the QoL following colorectal cancer surgery in both the patients and their spouses during the same time frame. The results of this study showed that patients as well as their spouses QoL was affected following colorectal cancer surgery.