SynthesisBJS open2021
Quality of life in restorative versus non-restorative resections for rectal cancer: systematic review.
Synthesis in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 26 citations in OpenAlex.
- Prognosis and quality of life in patients with locally advanced rectal cancer after abdominoperineal resection in the CAO/ARO/AIO-04 randomized phase 3 trial.Scientific reports · 2025Trial
- The Impact of Low Back Pain on the Self-Assessed Health-Related Quality of Life in Colostomy Patients-A Cross-Sectional Study.Journal of clinical medicine · 2026Article
- The Japan Society of Coloproctology Practice Guidelines for Fecal Incontinence 2024 (Revised Second Edition).Journal of the anus, rectum and colon · 2026Review
- Quality of life following total neoadjuvant therapy for rectal cancer.Journal of cancer research and clinical oncology · 2025Article
- Article
- Socio-economic predictors and between-hospital variation in permanent stoma rates after segmental resection of colorectal cancer. A population-based register study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- Study of Changes in Quality of Life After Rectal Cancer Surgery Using FACT-C Questionnaire.Indian journal of surgical oncology · 2025Article
- Preferences for treatment outcomes in rectal cancer: A discrete choice experiment among patients and healthy volunteers.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- Beyond survival: a comprehensive review of quality of life in rectal cancer patients.Annals of coloproctology · 2024Review
- Association between Physical Activity and Quality of Life in Colorectal Cancer Patients with Postoperative Defecatory Dysfunction: A Preliminary Survey.Healthcare (Basel, Switzerland) · 2024Article
- Shared Decision-Making, Sphincter Preservation, and Rectal Cancer Treatment: Identifying and Executing What Matters Most to Patients.Clinics in colon and rectal surgery · 2024Review
- Low Hartmann's procedure versus abdominoperineal resection for rectal cancer, a propensity score matching cohort study.BMC gastroenterology · 2024Article
- Exercise, Dietary Habits, and Defecatory Dysfunction in Patients Living with Colorectal Cancer: A Preliminary Quantitative Study.Healthcare (Basel, Switzerland) · 2024Article
- Article
- Permanent stoma rate and long-term stoma complications in laparoscopic, robot-assisted, and transanal total mesorectal excisions: a retrospective cohort study.Surgical endoscopy · 2024Article
- Major low anterior resection syndrome has equivalent health-related quality of life implications as having a permanent colostomy.Techniques in coloproctology · 2023Article
- Defecation Dysfunction and Exercise Habits among Survivors of Rectal Cancer: A Pilot Qualitative Study.Healthcare (Basel, Switzerland) · 2022Article
- Analysis of bowel function, urogenital function, and long-term follow-up outcomes associated with robotic and laparoscopic sphincter-preserving surgical approaches to total mesorectal excision in low rectal cancer: a retrospective cohort study.World journal of surgical oncology · 2022Article
- Quality of life and function after rectal cancer surgery with and without sphincter preservation.Frontiers in oncology · 2022Article
- Long-term Quality of Life After Surgery for Mid- and High Rectal Cancer: Hartmann's ProcedureIn vivo (Athens, Greece)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow 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.
methodsThe 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.
resultsNineteen 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.
conclusionCurrently, 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.