Quality of life refers to a persons general well being and encompasses all emotional, social and physical aspects of an individual’s life. Undergoing surgery and other treatments such as chemotherapy and radiation therapy, is not easy and can have a significant impact on a person’s life. Care and support during this difficult time is extremely important. This support should also continue during the follow up / surveillance period during which other symptoms may become more prominent, in particular regarding bowel, urinary and sexual dysfunction. Such functional problems cover a wide spectrum of symptoms and degrees of severity, and can subsequently affect emotional well-being and quality of life.
We therefore welcome you to complete a set of questionnaires to explore these functional aspects before and after surgery at regular intervals. In order to highlight any changes, we invite you to answer the questions at 3 and 6 months after surgery for the first year and then on an annual basis during your routine follow up period (see flow chart below). The surveys will help you and us identify any areas that may need attention and further investigation, to then be able to discuss treatment options that can improve your symptoms. All information is kept strictly confidential and only viewed by the medical team in charge of your care.
How do I access the questionnaires?
The questionnaires can be accessed and completed online via the educational TaTME website (LINK: www.TATME.surgery). You will therefore not have to attend any additional hospital appointments just for this. Your surgical team will provide you with your unique User ID (6 digits, usually starting with 100). You will need to enter this access code and your date of birth to view the questionnaire.
Further information on data collection and quality of life surveys can be found in this patient information sheet, here: PDF of Patient Info Sheet
When should I complete the questionnaire? If you don’t have a stoma:
If you do have a stoma:
Rectal cancer information
To improve oncological and functional outcomes of patients with rectal cancer new surgical techniques are being developed. The adoption of the Total Mesorectal Excision (TME) technique has resulted in better oncological outcome in the last decades. The addition of neoadjuvant therapy has further improved oncological outcome. The minimal invasive laparoscopic resection of rectal cancer has shown to be safe and to result in improved short-term outcomes and reduced morbidity. Nevertheless, the laparoscopic resection of mid and low rectal cancer remains challenging due to the anatomy of the narrow pelvis and is associated with a relative high risk of resections with tumour involved circumferential resection margins (CRM) resulting in increased risk of recurrence.The introduction of transanal single port surgery has led to the TaTME technique. In attempt to improve the quality of the TME procedure in low rectal cancer and further improve oncological results the transanal total mesorectal excision (TaTME) has been developed, in which the rectum is dissected transanally according to TME principles.
First series have been described since 2010 and although randomised evidence is still lacking this new technique has shown to be feasible and safe. The rectum including the total mesorectum is mobilised transanally in a reversed way with minimally invasive surgery including high quality imaging techniques. The TaTME technique for low and mid rectal cancer has shown to have potential benefits: better specimen quality with less CRM involvement, less morbidity as result of avoiding extraction wounds in the majority of patients and more sphincter saving rectal resections without compromising oncological outcomes. Currently, cohort series have demonstrated potential benefits of the TaTME for rectal cancer including a low rate of involved CRM, low morbidity rate and a high rate of sphincter saving procedures. Jurriaan Tuynman, MD, PhD, colorectal surgeon has introduced the technique in the VU medical center Amsterdam in 2013. Colin Sietses, MD, PhD, Colorectal surgeon has introduced this technique in Netherlands, EDE, since 2012.