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Article ; Online: Preoperative handgrip strength is not associated with complications and health-related quality of life after surgery for colorectal cancer.

van Heinsbergen, M / Konsten, J L / Bours, M J L / Bouvy, N D / Weijenberg, M P / Janssen-Heijnen, M L

2020 Volume 10, Issue 1, Page(s) 13005

Abstract: Colorectal cancer (CRC) treatment is associated with a high morbidity which may result in a reduced health-related quality of life (HRQoL). The pre-operative measurement of handgrip strength (HGS) might be a tool to predict the patient's outcome after ... ...

Abstract	Colorectal cancer (CRC) treatment is associated with a high morbidity which may result in a reduced health-related quality of life (HRQoL). The pre-operative measurement of handgrip strength (HGS) might be a tool to predict the patient's outcome after CRC surgery. The aim of this study was to evaluate the association of pre-operative HGS with the occurrence of postoperative complications and postoperative HRQoL. Stage I to III CRC patients ≥ 18 years were included at diagnosis. Demographic and clinical data as well as HGS were collected before start of treatment. HGS was classified as weak if it was below the gender-specific 25th percentile of our study population; otherwise HGS was classified as normal. The occurrence of postoperative complications within 30 days after surgery was collected from medical records. Cancer-specific HRQoL was measured 6 weeks after treatment using the EORTC QLQ-C30 and the EORTC QLQ-CR29 questionnaire. Of 295 patients who underwent surgical treatment for CRC, 67 (23%) patients had a weak HGS while 228 (77%) patients had normal HGS. 118 patients (40%) developed a postoperative complication. Complications occurred in 37% of patients with a weak HGS and in 41% of patients with a normal HGS (p = 0.47). After adjustment for age, sex, ASA, BMI and TNM, no significant associations between pre-operative HGS and the occurrence of postoperative complications and between HGS and HRQoL were found. We conclude that a single pre-operative HGS measurement was not associated with the occurrence of postoperative complications or post-treatment HRQoL in stage I-III CRC patients.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms/physiopathology ; Colorectal Neoplasms/surgery ; Female ; Hand Strength ; Humans ; Male ; Middle Aged ; Netherlands ; Postoperative Period ; Quality of Life
Language	English
Publishing date	2020-08-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-020-69806-1
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Article ; Online: Bowel dysfunction after sigmoid resection underestimated: Multicentre study on quality of life after surgery for carcinoma of the rectum and sigmoid.

van Heinsbergen, M / Janssen-Heijnen, M L / Leijtens, J W / Slooter, G D / Konsten, J L

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2018 Volume 44, Issue 8, Page(s) 1261–1267

Abstract: Aim: The Low Anterior Resection Syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. There are no data about functional complaints after sigmoid cancer surgery. We investigated LARS and QoL in patients with a resection for ...

Abstract	Aim: The Low Anterior Resection Syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. There are no data about functional complaints after sigmoid cancer surgery. We investigated LARS and QoL in patients with a resection for sigmoid cancer versus patients who had surgery for rectal cancer. Methods: 506 patients after resection for rectal or sigmoid cancer who were at least one year colostomy-free were included between January 2008 and December 2013. Bowel function was assessed by the LARS-Score. QoL was assessed by the EORTC QLQ-C30 and -CR29 questionnaires. QoL was compared between the LARS score categories and tumour height categories. Results: 412 respondents (81.5%) could be included for the analyses. The median interval since treatment was 5 years, and the median age at the follow-up point was 72 years. Major LARS increased significantly with decreasing tumour height from one fifth in sigmoid carcinoma to 90% in low rectum carcinoma. Female gender (OR = 2.162; 95% CI: 1.349-3.467), postoperative temporary diverting stoma (OR = 3.457; 95% CI: 2.019-5.919) and tumours located in the middle (OR = 3.193; 95% CI: 1.696-6.010) or lower rectum (OR = 8.247; 95% CI: 1.672-40.678) were independently associated with the development of major LARS. Patients with major LARS fared significantly worse in most QOL domains. Conclusions: For the first time, we found that functional abdominal complaints after sigmoid surgery are a major problem, with a negative effect on QoL, even 5 years after treatment. Patients need to be adequately informed about these long-term complaints.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Colon, Sigmoid/surgery ; Defecation/physiology ; Digestive System Surgical Procedures/adverse effects ; Fecal Incontinence/etiology ; Fecal Incontinence/physiopathology ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications/physiopathology ; Quality of Life ; Rectal Neoplasms/physiopathology ; Rectal Neoplasms/surgery ; Rectum/surgery ; Surveys and Questionnaires ; Syndrome
Language	English
Publishing date	2018
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2018.05.003
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Article ; Online: Quality of Life and Bowel Dysfunction after Transanal Endoscopic Microsurgery for Rectal Cancer: One Third of Patients Experience Major Low Anterior Resection Syndrome.

van Heinsbergen, Maarten / Leijtens, Jeroen W / Slooter, Gerrit D / Janssen-Heijnen, Maryska L / Konsten, Joop L

Digestive surgery

2019 Volume 37, Issue 1, Page(s) 39–46

Abstract: Background/aims: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. Studies investigating LARS and the effect on QoL after transanal endoscopic microsurgery (TEM) for rectal cancer are scarce. ... ...

Abstract	Background/aims: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. Studies investigating LARS and the effect on QoL after transanal endoscopic microsurgery (TEM) for rectal cancer are scarce. The aim of our study was to assess bowel dysfunction and QoL after TEM. Methods: Seventy-three -patients who underwent TEM for stage I rectal cancer were included in this single-centre, cross-sectional study Bowel dysfunction was assessed by the LARS-Score, QoL by the -European Organization for the Research and Treatment of Cancer QLQ-C30 and -CR29 questionnaires. Results: Fifty-five respondents (75.3%) could be included for the analyses. The median interval since treatment was 4.3 years, and the median age at the follow-up point was 72 years. "Major LARS" was observed in 29% of patients and "minor LARS" in 26%. Female gender (OR 4.00; 95% CI 1.20-13.36), neo-adjuvant chemoradiotherapy (OR 3.63; 95% CI 1.08-12.17) and specimen thickness in millimetres (OR 1.10 for each mm increase in thickness; 95% CI 1.01-1.20) were associated with the development of major LARS. Patients with major LARS fared worse in most QoL domains. Conclusion: This is the first study demonstrating major LARS after TEM treatment for rectal cancer, with a negative effect on QoL, even years after treatment. Our data provides an adequate counselling before TEM in terms of postoperative bowel dysfunction and its effect on QoL.
MeSH term(s)	Aged ; Aged, 80 and over ; Colectomy/adverse effects ; Cross-Sectional Studies ; Female ; Humans ; Intestinal Diseases/etiology ; Intestinal Diseases/physiopathology ; Male ; Middle Aged ; Proctectomy/adverse effects ; Quality of Life ; Rectal Neoplasms/physiopathology ; Rectal Neoplasms/surgery ; Rectal Neoplasms/therapy ; Rectum/physiopathology ; Rectum/surgery ; Syndrome ; Transanal Endoscopic Microsurgery/adverse effects
Language	English
Publishing date	2019-06-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	605888-7
ISSN	1421-9883 ; 0253-4886
ISSN (online)	1421-9883
ISSN	0253-4886
DOI	10.1159/000496434
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Article: Functional Bowel Complaints and the Impact on Quality of Life After Colorectal Cancer Surgery in the Elderly.

Ketelaers, Stijn H J / van Heinsbergen, Maarten / Orsini, Ricardo G / Vogelaar, F Jeroen / Konsten, Joop L M / Nieuwenhuijzen, Grard A P / Rutten, Harm J T / Burger, Jacobus W A / Bloemen, Johanne G

Frontiers in oncology

2022 Volume 12, Page(s) 832377

Abstract: Background: The Low Anterior Resection Syndrome (LARS) is commonly reported after colorectal cancer surgery and significantly impairs quality of life. The prevalence and impact of LARS in the elderly after rectal cancer as well as colon cancer surgery ... ...

Abstract	Background: The Low Anterior Resection Syndrome (LARS) is commonly reported after colorectal cancer surgery and significantly impairs quality of life. The prevalence and impact of LARS in the elderly after rectal cancer as well as colon cancer surgery is unclear. We aimed to describe the prevalence of LARS complaints and the impact on quality of life in the elderly after colorectal cancer surgery. Materials and methods: Patients were included from seven Dutch hospitals if they were at least one year after they underwent colorectal cancer surgery between 2008 and 2015. Functional bowel complaints were assessed by the LARS score. Quality of life was assessed by the EORTC QLQ-C30 and EORTC QLQ-CR29 questionnaires. Outcomes in patients ≥70 years were compared to a reference group of patients <70 years. Results: In total 440 rectal cancer and 1183 colon cancer patients were eligible for analyses, of whom 133 (30.2%) rectal and 536 (45.3%) colon cancer patients were ≥70 years. Major LARS was reported by 40.6% of rectal cancer and 22.2% of colon cancer patients ≥70 years. In comparison, patients <70 years reported major LARS in 57.3% after rectal cancer surgery (p=0.001) and in 20.4% after colon cancer surgery (p=0.41). Age ≥70 years was independently associated with reduced rates of major LARS after rectal cancer surgery (OR 0.63, Conclusion: Elderly should not be withheld a restorative colorectal cancer resection based on age alone. However, a substantial part of the elderly colorectal cancer patients develops major LARS after surgery, which often severely impairs quality of life. Since elderly frequently consider quality of life and functional outcomes as one of the most important outcomes after treatment, major LARS and its impact on quality of life should be incorporated in the decision-making process.
Language	English
Publishing date	2022-02-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.832377
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Article ; Online: Functional bowel complaints and quality of life after surgery for colon cancer: prevalence and predictive factors.

van Heinsbergen, M / den Haan, N / Maaskant-Braat, A J / Melenhorst, J / Belgers, E H / Leijtens, J W / Bloemen, J G / Rutten, H J / Bouvy, N D / Janssen-Heijnen, M L / Konsten, J L

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2019 Volume 22, Issue 2, Page(s) 136–145

Abstract: Aim: Low anterior resection syndrome (LARS) severely affects the quality of life (QoL) of patients after surgery for rectal cancer. There are very few studies that have investigated LARS-like symptoms and their effect on QoL after colon cancer surgery. ... ...

Abstract	Aim: Low anterior resection syndrome (LARS) severely affects the quality of life (QoL) of patients after surgery for rectal cancer. There are very few studies that have investigated LARS-like symptoms and their effect on QoL after colon cancer surgery. The aim of this study was to investigate the prevalence of functional abdominal complaints and related QoL after colon cancer surgery compared with patients with similar complaints after rectal cancer surgery. Method: All patients who underwent colorectal cancer resections between January 2008 and December 2015, and who were free of colostomy for at least 1 year, were eligible (n = 2136). Bowel function was assessed by the LARS score, QoL by the EORTC QLQ-C30 and QLQ-CR29 questionnaires. QoL was compared between the LARS score categories and tumour height categories. Results: A total of 1495 patients (70.0%) were included in the analyses, of whom 1145 had a colonic and 350 a rectal tumour. Symptoms of LARS were observed in 55% after rectal cancer resection compared with 21% after colon cancer resection. Female gender (OR 1.88, CI 1.392-2.528) and a previous diverting stoma (OR 1.84, CI 1.14-2.97) were independently associated with a higher prevalence of LARS after colon cancer surgery. Patients with LARS after colon cancer surgery performed significantly worse in most QoL domains. Conclusion: The results of this study highlight the presence of LARS-like symptoms after surgery for colonic cancer. Patients suffering from major LARS-like symptoms after colon resection reported the same debilitating effect on their QoL as patients with major LARS after rectal resection. This should be addressed by colorectal cancer specialists in order to adequately inform patients.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Colectomy/adverse effects ; Colectomy/psychology ; Colonic Neoplasms/psychology ; Colonic Neoplasms/surgery ; Cross-Sectional Studies ; Defecation ; Female ; Gastrointestinal Diseases/epidemiology ; Gastrointestinal Diseases/etiology ; Gastrointestinal Diseases/psychology ; Humans ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/psychology ; Prevalence ; Proctectomy/adverse effects ; Proctectomy/psychology ; Quality of Life ; Rectal Neoplasms/surgery ; Retrospective Studies ; Risk Factors ; Sex Factors ; Syndrome ; Treatment Outcome
Language	English
Publishing date	2019-09-03
Publishing country	England
Document type	Comparative Study ; Journal Article ; Multicenter Study
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.14818
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Article ; Online: Implementation of a Postoperative Screening and Treatment Guidance for the Low Anterior Resection Syndrome: Preliminary Results.

van der Heijden, Joost A G / van Heinsbergen, Maarten / Thomas, Gwendolyn / Caers, Freeke / Slooter, Gerrit D / Maaskant-Braat, Adriana J G

Diseases of the colon and rectum

2019 Volume 62, Issue 9, Page(s) 1033–1042

Abstract: Background: Even years after a low anterior resection, many patients experience persisting bowel complaints. This is referred to as low anterior resection syndrome and has a severe adverse effect on quality of life. Its diverse nature makes it difficult ...

Abstract	Background: Even years after a low anterior resection, many patients experience persisting bowel complaints. This is referred to as low anterior resection syndrome and has a severe adverse effect on quality of life. Its diverse nature makes it difficult to find a gold-standard therapy for this syndrome. However, most importantly, postoperative guidance appears to be suboptimal. Objective: The purpose of this study was to describe and evaluate the implementation of a multimodel guidance with structured screening and treatment options. Design: A retrospective, comparative, cross-sectional study was conducted. Data of patients treated before protocol implementation were compared with a cohort after implementation. Settings: This was a single-center study. Patients: Patients seen after low anterior resection or sigmoid resection between 2010 and 2017 for colorectal malignancy were included. Intervention: This included implementation of a postoperative guidance protocol. Main outcome measures: Bowel dysfunction was assessed by the low anterior resection score, whereas the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires (C30 and CR29) assessed general and colorectal-specific quality of life. Results: A total of 243 patients were included; 195 were guided before and 48 after protocol implementation. Patients who underwent low anterior resection after protocol implementation showed significantly lower median low anterior resection scores (31 vs 18; p = 0.02) and less major low anterior resection syndrome (51.9% vs 26.3%; p = 0.045). Patients who underwent sigmoid resection did not present with similar changes. Multiple quality-of-life domains showed clinically significant positive changes since our postoperative protocol was implemented. Limitations: Patient characteristics are not comparable between groups, which makes it difficult to draw firm conclusions. Conclusions: We recommend that others reconsider their current postoperative management for patients with rectal cancer and suggest a change to a comparable noninvasive, patient-driven postoperative guidance to enhance patient coping mechanisms and self-management and therefore improve their quality of life. See Video Abstract at http://links.lww.com/DCR/A970. IMPLEMENTACIÓN DE UNA GUÍA POSTOPERATORIA DE DETECCIÓN Y TRATAMIENTO PARA EL SÍNDROME DE RESECCIÓN ANTERIOR BAJA: RESULTADOS PRELIMINARES: Incluso años después de una resección anterior baja, muchos pacientes experimentan quejas intestinales persistentes. Esto se conoce como síndrome de resección anterior baja y tiene un efecto adverso grave en la calidad de vida. Su naturaleza diversa hace que sea difícil encontrar una terapia patrón de oro para este síndrome. Pero lo más importante, la guía postoperatoria parece ser subóptima. Objetivo: Describir y evaluar la implementación de una guía de múltiples modelos con opciones estructuradas de selección y tratamiento. Diseno: Se realizó un estudio retrospectivo de corte transversal comparativo. Los datos de los pacientes tratados antes de la implementación del protocolo se compararon con una cohorte después de la implementación. Marco: Centro de estudio único. Pacientes: Pacientes después de resección anterior baja o resección sigmoidea entre 2010-2017 por neoplasia colorectal. INTERVENCIÓN:: La implementación de un protocolo de guía postoperatoria. Principales medidas de resultado: La disfunción intestinal se evaluó mediante la puntuación de resección anterior baja, mientras que la Organización Europea para la Investigación y Tratamiento de Cuestionarios de Calidad de Vida del Cáncer (C30 y CR29) evaluó la calidad de vida general y específicamente colorectal. Resultados: Se incluyeron 243 pacientes, 195 fueron guiados antes y 48 después de la implementación del protocolo. Los pacientes que se sometieron a una resección anterior baja después de la implementación del protocolo mostraron puntuaciones de resección anterior bajas medias significativamente más bajas (31 frente a 18; p = 0,02) y menos puntuaciones de síndrome de resección anterior baja (51,9% frente a 26,3%; p = 0,045). Los pacientes sometidos a resección sigmoidea no presentaron cambios similares. Los múltiples dominios de calidad de vida mostraron cambios positivos clínicamente significativos desde que se implementó nuestro protocolo postoperatorio. Limitaciones: Las características de los pacientes no son comparables entre los grupos, lo que dificulta sacar conclusiones firmes. CONCLUSIÓNES:: Recomendamos a otros que reconsideren su manejo postoperatorio actual para pacientes con cáncer de recto y sugerimos un cambio a una guía postoperatoria impulsada por el paciente no invasiva comparable para mejorar los mecanismos de afrontamiento y el autocontrol de los pacientes y, por lo tanto, mejorar su calidad de vida. Vea el Video del Resumen en http://links.lww.com/DCR/A970.
MeSH term(s)	Aged ; Colectomy/adverse effects ; Colon, Sigmoid/surgery ; Colorectal Neoplasms/surgery ; Cross-Sectional Studies ; Disease Management ; Female ; Follow-Up Studies ; Humans ; Male ; Postoperative Care/methods ; Postoperative Complications/diagnosis ; Postoperative Complications/therapy ; Practice Guidelines as Topic ; Retrospective Studies ; Syndrome
Language	English
Publishing date	2019-07-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000001428
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Article ; Online: Intrapelvic Retroperitoneal Synovial Sarcoma in a 15-Year-Old Adolescent Girl: A Case Report and Review of the Literature.

Bessems, Stan A / van Heinsbergen, Maarten / Nijhuis, Paul H / van de Ven, Kees C P / Aarts, Frits

Journal of pediatric hematology/oncology

2019 Volume 41, Issue 8, Page(s) 627–631

Abstract: Synovial sarcomas are a rare subtype of soft tissue sarcomas mostly located in the lower extremities. The authors report a case of synovial sarcoma in a 15-year-old adolescent girl with several unusual features including age, intrapelvic retroperitoneal ... ...

Abstract	Synovial sarcomas are a rare subtype of soft tissue sarcomas mostly located in the lower extremities. The authors report a case of synovial sarcoma in a 15-year-old adolescent girl with several unusual features including age, intrapelvic retroperitoneal location of the primary tumor, and presentation with right abdominal tenderness and compression of the iliac vessels with thrombosis of the right iliac and femoral vein.
MeSH term(s)	Adolescent ; Constriction, Pathologic/pathology ; Constriction, Pathologic/physiopathology ; Female ; Humans ; Iliac Vein/pathology ; Iliac Vein/physiopathology ; Retroperitoneal Neoplasms/pathology ; Retroperitoneal Neoplasms/physiopathology ; Sarcoma, Synovial/pathology ; Sarcoma, Synovial/physiopathology ; Venous Thrombosis/pathology ; Venous Thrombosis/physiopathology
Language	English
Publishing date	2019-08-15
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1231152-2
ISSN	1536-3678 ; 1077-4114 ; 0192-8562
ISSN (online)	1536-3678
ISSN	1077-4114 ; 0192-8562
DOI	10.1097/MPH.0000000000001583
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Article ; Online: The low anterior resection syndrome in a reference population: prevalence and predictive factors in the Netherlands.

van Heinsbergen, M / Van der Heijden, J A G / Stassen, L P / Melenhorst, J / de Witte, E / Belgers, E H / Maaskant-Braat, A J G / Bloemen, J G / Bouvy, N D / Janssen-Heijnen, M L / Konsten, J L

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2019 Volume 22, Issue 1, Page(s) 46–52

Abstract: Aim: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after colorectal cancer surgery. There are no data about these complaints and the association with QoL in a reference population. The aim of this study was to assess ... ...

Abstract	Aim: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after colorectal cancer surgery. There are no data about these complaints and the association with QoL in a reference population. The aim of this study was to assess LARS and the association with QoL in a reference population. Methods: Six hundred patients who visited the outpatient clinic because of general or trauma surgical indications were asked to participate in this study. They received an invitation letter containing three validated questionnaires to assess LARS (assessed with the LARS score) and both general [European Organization for the Research and Treatment of Cancer (EORTC) QLQ-C30] and colorectal-specific (EORTC QLQ-CR29) QoL. Results: Five hundred and one respondents could be included for the analyses. The median age at inclusion was 68 years and 47.3% were men. Major LARS was observed in 15% of patients (11.4% in men and 18.9% in women, P = 0.021). Women reported more urgency (P = 0.070) and incontinence for both flatus (P < 0.001) and stool (P = 0.063) compared to men. In univariate analyses, women reported major LARS significantly more often than men (OR 1.82; 95% CI 1.10-3.01). Patients with major LARS scored significantly worse in most QoL domains compared to patients with no/minor LARS. Conclusion: This is the first study demonstrating major LARS and the association with QoL in a reference population of patients without colorectal cancer. Our data can assist in the interpretation of LARS in past and future research about abdominal complaints after colorectal cancer surgery.
MeSH term(s)	Aged ; Anal Canal/physiopathology ; Anal Canal/surgery ; Colectomy/adverse effects ; Colectomy/psychology ; Colorectal Neoplasms/physiopathology ; Colorectal Neoplasms/psychology ; Colorectal Neoplasms/surgery ; Defecation ; Fecal Incontinence/epidemiology ; Fecal Incontinence/etiology ; Fecal Incontinence/psychology ; Female ; Humans ; Male ; Netherlands/epidemiology ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/psychology ; Postoperative Period ; Prevalence ; Proctectomy/adverse effects ; Proctectomy/psychology ; Quality of Life ; Rectal Diseases/epidemiology ; Rectal Diseases/etiology ; Rectal Diseases/psychology ; Risk Factors ; Surveys and Questionnaires ; Syndrome
Language	English
Publishing date	2019-08-21
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.14790
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Article ; Online: Follow-up after surgical treatment in older patients with colorectal cancer: The evaluation of emerging health problems and quality of life after implementation of a standardized shared-care model.

van Heinsbergen, Maarten / Maas, Huub / Bessems, Stan / Vogelaar, Jeroen / Nijhuis, Paul / Keijzer-Bors, Liliane / van Liempd, Angela / Janssen-Heijnen, Maryska

Journal of geriatric oncology

2018 Volume 10, Issue 1, Page(s) 126–131

Abstract: Introduction: One-year mortality after hospital discharge is higher among older patients with colorectal cancer who underwent surgery compared to younger patients. Taking care of older adults with multi-morbidity is often fragmented with lack of ... ...

Abstract	Introduction: One-year mortality after hospital discharge is higher among older patients with colorectal cancer who underwent surgery compared to younger patients. Taking care of older adults with multi-morbidity is often fragmented with lack of coordination and information exchange between healthcare professionals. The aim of this study was to evaluate emerging health problems and quality of life after implementing a standardized shared-care model. Material and methods: 141 patients aged ≥70 years who underwent surgery for colorectal carcinoma in two hospitals were included. A standardized transmission from hospital to primary care was set up. Patients' health status and quality of life was evaluated during subsequent follow-up moments. Results: A reduction in one-year mortality rate from 10.9% to 9.2% was observed after implementation of the standardized shared-care model. Almost all health status domains improved to 'good' during follow-up moments, still the general condition remained poor in 26% of patients at week fourteen. Although quality of life improved during subsequent follow-up moments, fatigue, dyspnoea and insomnia were the most prominent persisting problems at the end of follow-up. Discussion: The implementation of a standardized shared-care model for older patients after surgery for colorectal cancer resulted in a reduction in the one year mortality rate. Although most aspects of both health status and quality of life improved during subsequent follow-up moments, especially the general condition remained poor for a long time after surgery. This means that, besides a good preoperative counseling of patients, future research should focus on possible interventions to improve general condition.
MeSH term(s)	Aftercare/methods ; Aftercare/standards ; Aged ; Aged, 80 and over ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/rehabilitation ; Colorectal Neoplasms/surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Oncology/methods ; Medical Oncology/standards ; Quality of Life ; Retrospective Studies ; Surveys and Questionnaires ; Survival Analysis
Language	English
Publishing date	2018-08-11
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2556813-9
ISSN	1879-4076 ; 1879-4068
ISSN (online)	1879-4076
ISSN	1879-4068
DOI	10.1016/j.jgo.2018.07.014
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Article ; Online: Awareness and management of low anterior resection syndrome: A Dutch national survey among colorectal surgeons and specialized nurses.

Thomas, Gwendolyn / van Heinsbergen, Maarten / van der Heijden, Joost / Slooter, Gerrit / Konsten, Joop / Maaskant, Sabrina

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2018 Volume 45, Issue 2, Page(s) 174–179

Abstract: Introduction: Substantial progress has been made in the treatment of rectal cancer in the past two decades. Low anterior resection is a cornerstone in current treatment, combined with neo-adjuvant (chemo-) radiation in selected cases. However, side ... ...

Abstract	Introduction: Substantial progress has been made in the treatment of rectal cancer in the past two decades. Low anterior resection is a cornerstone in current treatment, combined with neo-adjuvant (chemo-) radiation in selected cases. However, side effects such as increased frequency, urgency and incontinence are seen in a majority of patients postoperatively. These symptoms, referred to as low anterior resection syndrome (LARS), have a severe impact on quality of life. Management of LARS is complex, and surgeons seem to underestimate and misinterpret the impact of symptoms associated with LARS. Aim and methods: We investigated the awareness and management of LARS in The Netherlands, conducting a national survey in which colorectal surgeons and colorectal care nurses were asked for their views on this complex syndrome. Results: 242 health-care professionals participated in the survey. Most participants estimate the prevalence of major LARS is 20-40% after low anterior resection (LAR); a severe underestimation of actual prevalence - around 70%. Only 10% of surgeons use LARS screening tools in the preoperative period, and fewer than half of surgeons use LARS scores before or after a LAR. Although most surgeons inform their patients preoperatively about the changes in bowel function that they may experience after rectal cancer treatment, a majority of these surgeons indicate more information and patient counselling would improve the quality of life of their patients. Discussion: Impact and prevalence of LARS is underestimated by their physicians. Uniform clinical guidelines should be developed to guide physicians in adequate management of patients with LARS.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Awareness ; Digestive System Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Netherlands/epidemiology ; Postoperative Complications/epidemiology ; Postoperative Complications/therapy ; Prevalence ; Quality of Life ; Rectal Neoplasms/surgery ; Risk Factors ; Surveys and Questionnaires ; Syndrome
Language	English
Publishing date	2018-11-10
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2018.11.001
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