How do patients having undergone laparoscopic colectomy cope with this procedure? A review of patients’ quality of life including several studies provides a few indicators.
1| Colectomy, a reference treatment for colon cancer
Colon cancer is the third most common cancer in men and the second most common in women in France, with more than 43,000 new cases each year and approximately 17,117 deaths, according to Santé Publique France. The 5-year survival rate is 60.3%.1
Laparoscopic colectomy is increasingly used to treat colon cancer, with results at least equivalent to those obtained by open colectomy.2
Laparoscopic colectomy is what is known as a minimally-invasive surgical procedure and is associated with shorter hospitalization. The technique may reduce postoperative pain, with good results in terms of patient recovery.3
2| Patient quality of life after laparoscopic colectomy
Laparoscopic colectomy has proved its efficacy in the treatment of colon cancer, but it is nonetheless interesting to assess the quality of life of the patients concerned. A review describes the quality of life of patients having undergone laparoscopic colectomy following cancer. This review is based on several studies carried out using assessment questionnaires. A total of 20 studies were taken into account.
Most of the studies included in the review report a gradual improvement in the first 3 months following the surgery. The majority of the postoperative effects, such as pain, reduced appetite and fatigue, are reduced after 3 months. Most of the studies reveal an improvement in social function over this period too, except for one British study, which reports the persistence of physical and social difficulties for up to 3 years after the procedure.5 According to the researchers, this difference may be explained by divergences in the type of population surveyed and in the support received during their convalescence. It was also observed that social functioning one month after the procedure obtained a better score than in patients having undergone invasive surgery, significantly influencing patients’ quality of life. Finally, older patients are more likely to encounter difficulties in general during the first year following laparoscopic colectomy.4
The conclusions of this review are instructive, although they need to be put into perspective since the assessment scales used can vary from one study to another. However, the feedback and quality of life reported may be useful in preoperative consultations to help reassure, inform and best prepare patients for a future laparoscopic colectomy.
- Bayar R, Mzoughi Z, Djebbi A, Halek G, Khalfallah MT. Colectomie laparoscopique versus colectomie par laparotomie dans le traitement des adénocarcinomes coliques non métastatiques [Laparoscopic colectomy versus colectomy performed via laparotomy in the treatment of non-metastatic colic adenocarcinomas]. Pan Afr Med J. 2016;25:165. Published 2016 Nov 16. doi:10.11604/pamj.2016.25.165.10071
- Chang GJ, Nelson H. Laparoscopic colectomy. Curr Gastroenterol Rep. 2005;7(5):396-403. doi:10.1007/s11894-005-0010-4
- Theodoropoulos GE, Karantanos T. Quality of life after laparoscopic colectomy for cancer. JSLS. 2014;18(2):225-235. doi:10.4293/108680813X13753907291152
- Jayne DG, Guillou PJ, Thorpe H, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol. 2007;25:3061–3068