Quality of Life After Abdomioperineal Resection for Rectal Carcinoma

Background: Abdominoperineal resection (APR) has long been a standard treatment for rectal cancer, particularly for tumors located very distally or in patients with poor sphincter function. Despite the rise of sphincter-sparing techniques, APR remains essential in certain cases. This study aims to evaluate the impact of APR on the quality of life (QoL) in rectal cancer patients. Objective: To assess the quality of life in rectal cancer patients following APR, focusing on physical, psychological, sexual, and social functioning. Method: This prospective observational study was conducted at Sher-e-Bangla Medical College & Hospital, Barisal, over six months (July-December 2015). Patients who underwent APR for rectal cancer and were at least three months post-surgery were included. QoL was evaluated based on patients' self-assessments across four dimensions: physical, psychological, sexual, and social functioning. Result: The study included patients with a mean age of 48 years (range: 23-75 years), with 40% being early middle-aged (31-40 years). Stoma-related issues were reported by 56% of patients, while 64% experienced odor problems. Psychological distress was prevalent, with 52% feeling discomfort, 44% experiencing depression or anxiety, and 12% reporting suicidal tendencies. Sexual dysfunction was significant, affecting 55% of men, with 83.8% completely impotent. Social functioning was compromised, with 42% reducing social activities. Overall, 24% of patients rated their QoL as poor, 14% as extremely poor, 26% as average, and 36% as good. Conclusion: Rectal cancer patients post-APR experience considerable limitations across all QoL dimensions, underscoring the need for targeted interventions to improve their overall well-being.