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When do defecation function and quality of life recover for patients with non-ostomy and ostomy surgery of rectal cancer?
BMC Surgery ( IF 1.6 ) Pub Date : 2020-03-30 , DOI: 10.1186/s12893-020-00719-6
Guojun Tong 1, 2 , Guiyang Zhang 1 , Jian Liu 1, 3 , Zhaozheng Zheng 1 , Yan Chen 1 , Min Li 4 , Yan Zhong 4 , Pingping Niu 2 , Xuting Xu 2
Affiliation  

Rectal cancer (RC) surgery often results in permanent colostomy, seriously limiting the quality of life (QOL) in patients in terms of bowel function. This study aimed to examine defecation function and QOL in RC patients who underwent non-ostomy or ostomy surgery, at different time-points after surgery. In total, 82 patients who underwent an ostomy and 141 who did not undergo an ostomy for the treatment of RC at our colorectal surgery department between January 2013 and January 2015 were enrolled. Surgical methods, tumor distance from the anal margin (TD), anastomosis distance from the anal margin (AD) and complications were compered between the non-ostomy and ostomy surgery groups. QOL was compared between the two groups at years 2, 3, and 4 after surgery. The Wexner score and the validated cancer-specific European Organization for Research and Treatment of Cancer (EORTC QLQ-CR30) questionnaire scores were assessed for all patients in January 2017. SPSS 21.0 was utilized for all data analyses. Surgical methods, TD, and AD significantly differed between the non-ostomy and ostomy surgery groups (all P < .001). However, no differences were found in the number of complications between the groups (P = .483). For the 192 patients undergoing Dixon surgery, role function (RF), global QOL (GQOL), sleep disturbance, and the incidence of constipation showed significant differences between the two groups (P = .012, P = .025, P = .036, and P = .015, respectively). In the 31 cases of permanent ostomy, we observed significant differences in GQOL scores, dyspnea incidence, and financial difficulties across the different years (P = .002, P = .036, and P < .01, respectively). Across all 223 cases, there were significant differences in social function and GQOL scores in the second year after surgery (P = .014 and P < .001, respectively). However, no differences were observed in the other indices across the three time-points. RC patients undergoing ostomy surgery, especially those with low and super-low RC, revealed poorer defecation function and QOL in the present study. However, 2 years after surgery, most of the defecation and QOL indicators showed recovery.

中文翻译:

非直肠造口术和直肠造口术患者的排便功能和生活质量何时恢复?

直肠癌(RC)手术通常会导致永久性结肠造口术,严重影响患者肠功能的生活质量(QOL)。这项研究的目的是检查在术后不同时间点接受非造口术或造口术的RC患者的排便功能和生活质量。在2013年1月至2015年1月期间,我们共计82例接受造口术的患者和141例未经造口术治疗RC的患者入选。在非造口术和造口术手术组之间,对手术方法,距肛门边缘的肿瘤距离(TD),距肛门边缘的吻合距离(AD)和并发症进行了比较。在手术后第2、3和4年比较两组的生活质量。2017年1月,对所有患者进行了Wexner评分和经过验证的针对癌症的欧洲癌症研究与治疗组织(EORTC QLQ-CR30)问卷调查评分。所有数据分析均采用SPSS 21.0。非造口术和造口术手术组之间的手术方法,TD和AD有显着差异(所有P <0.001)。但是,两组之间的并发症数量没有差异(P = .483)。对于192位接受Dixon手术的患者,角色功能(RF),整体QOL(GQOL),睡眠障碍和便秘的发生率在两组之间有显着差异(P = .012,P = .025,P = .036 ,且P分别为.015)。在31例永久性造口术中,我们观察到GQOL评分,呼吸困难发生率,和不同年份的财务困难(分别为P = .002,P = .036和P <.01)。在所有223例病例中,术后第二年的社交功能和GQOL评分均存在显着差异(分别为P = .014和P <.001)。但是,在三个时间点上,其他指标均未观察到差异。在本研究中,接受造瘘术的RC患者,尤其是RC低和超低的患者,排便功能和QOL较差。然而,术后2年,大多数排便和QOL指标均显示恢复。在三个时间点上,其他指标均未观察到差异。在本研究中,接受造瘘术的RC患者,尤其是RC低和超低的患者,排便功能和QOL较差。但是,术后2年,大多数排便和QOL指标均显示恢复。在三个时间点上,其他指标均未观察到差异。在本研究中,接受造瘘术的RC患者,尤其是RC低和超低的患者,排便功能和QOL较差。但是,术后2年,大多数排便和QOL指标均显示恢复。
更新日期:2020-04-22
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