Observational studyJournal of gastrointestinal cancer2026
Quality‑of‑Life Outcomes of Appendicostomy-Colostomy Integration in Abdominoperineal Resection: A Multicenter Prospective Cohort Study.
Observational study in Journal of gastrointestinal cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
backgroundAbdominoperineal resection (APR) for very low rectal cancer often causes long-term QoL issues due to a permanent colostomy and pelvic morbidity. Dual-stoma techniques, like appendicostomy-enabled irrigation, might enhance bowel control and psychosocial recovery, but these methods need more study in large prospective cohorts.
objectiveAppendicostomy with abdominal colostomy during APR improves long-term QoL without increasing complications.
methodsA ten-year prospective cohort study across three Iranian colorectal centers involved 130 participants undergoing standardized APR with dual-stoma formation, including a permanent colostomy and appendicostomy. QoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the colorectal cancer-specific module (QLQ-CR29) at 12, 18, and 24 months. Missing responses were addressed through multiple imputation. Nonparametric methods like Mann-Whitney, Kruskal-Wallis, and Spearman's correlation evaluated trends and disparities across domains and sociodemographic variables.
resultsThe mean QoL score was 81.5 ± 11.3. Functional domains, including cognitive (94.6 ± 12.5), role (89.5 ± 13.5), and physical (85.0 ± 12.1), remained consistently high. CR29 scores indicated strong body image (75.9 ± 16.0), minimal stoma-related embarrassment (29.5 ± 21.0), and maintained sexual function (74.9 ± 24.6 among active respondents). Issues concerning appendicostomy management were minimal, with 91.5% of participants reporting ease of use; no severe complications were observed. Persistent concerns included financial burden (35.6 ± 23.2) and mild peri-stomal symptoms.
conclusionDual-stoma APR with appendicostomy is a safe, feasible, and associated with favorable physical, psychosocial, and functional QoL outcomes.
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