Short-term Prospective Questionnaire Study of Early Postoperative Quality of Life After Colorectal Endoscopic Submucosal Dissection

Abstract

Background: Endoscopic submucosal dissection (ESD) has become popular as an alternative to laparoscopy-assisted colectomy (LAC) for early colorectal cancer.

Aim: To validate postoperative quality of life (QOL) based on subjective symptoms of patients from questionnaire survey.

Methods: We prospectively enrolled patients planned to undergo ESD for adenoma or Tis/T1a cancer at our institution between December 2011 and January 2013. Controls were prospectively enrolled LAC patients diagnosed with T1b cancer. Patients answered questionnaire survey on QOL on postoperative day (POD) 1 and POD14. Questions were scored using visual analog scale (0 points = worst condition, 100 points = best condition) and were classified into six categories: health status, mental status (MeS), motor status (MoS), bodily painless, passage and anorectal function (PAF), and stress for the treatment. Total score was also calculated. We compared the median scores among categories using the Wilcoxon rank-sum test.

Results: A total of 82 ESDs and 41 LACs were included. Median score for the factors in questionnaire (POD1/POD14) in ESDs versus LACs for colonic lesion (rectal lesion) was as follows: MeS, 74/83 versus 54/73 (72/85 vs. 42/62); MoS, 98/96 versus 51/75 (95/90 vs. 66/67); PAF, 90/96 versus 80/80 (90/95 vs. 70/53); total score, 83/91 versus 58/75 (81/87 vs. 51/66). These items showed statistical significant differences between ESDs and LACs.

Conclusions: Postoperative QOL and symptoms are significantly better on POD1 and POD14 following ESD compared with LAC.

Keywords: Colon; Early colorectal cancer; Endoscopic submucosal dissection (ESD); Laparoscopy-assisted colectomy (LAC); Quality of life (QOL); Questionnaire.