Risk factors for sexual dysfunction after rectal cancer treatment
Risk factors for sexual dysfunction after rectal cancer treatment
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DOI：
10.1016/j.ejca.2008.12.014
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发表时间：
2009-06-01
影响因子：
8.4
通讯作者：
van de Velde, C. J. H.
中科院分区：
文献类型：
--
作者：
Lange, M. M.;Marijnen, C. A. M.;van de Velde, C. J. H.
本研究旨在确定直肠癌治疗后长期性功能障碍(SD)的危险因素。将可切除直肠癌患者随机分为全直肠系膜切除加或不加术前放射治疗(PRT)。分别于术前、术后3、6、12、18、24个月进行问卷调查。通过单因素和多因素回归分析，发现76.4%、79.8%和72.2%的男性患者总体SD增加，勃起功能障碍和射精问题分别占男性患者的76.4%和72.2%。危险因素包括神经损伤、失血、吻合口漏、PRT和吻合口存在。在女性患者中，一般SD、性交困难和阴道干燥的发生率分别增加了61.5%、59.1%和56.6%。这与PRT和胃的存在有关。SD在直肠癌治疗后经常发生，是由外科(神经)损伤和PRT的额外影响引起的。术前应告知患者，对外科医生进行神经解剖学教育可能是改善功能预后的关键。(C)2008爱思唯尔有限公司。保留所有权利。
This study aimed to identify risk factors for long-term sexual dysfunction (SD) after rectal cancer treatment.Patients with resectable rectal cancer were randomised to total mesorectal excision with or without preoperative radiotherapy (PRT). Preoperatively and at 3, 6, 12, 18 and 24 months postoperatively, SD scores were filled out in questionnaires. Possible risk factors for postoperative deterioration of sexual functioning, including patients' demographics, tumour-specific factors and treatment-related variables, were investigated with univariate and multivariable regression analyses.Increase in general SD, erectile dysfunction and ejaculatory problems were reported by 76.4, 79.8 and 72.2 percent of the male patients, respectively. Risk factors were nerve damage, blood loss, anastomotic leakage, PRT and the presence of a stoma. In female patients, increase in general SD, dyspareunia and vaginal dryness were reported by 61.5, 59.1 and 56.6 percent, respectively. This was associated with PRT and the presence of a stoma.SD occurs frequently after rectal cancer treatment and is caused by surgical (nerve) damage with an additional effect of PRT. Patients should be informed preoperatively, and education of surgeons in neuroanatomy may provide the key to the improvement of functional outcome. (c) 2008 Elsevier Ltd. All rights reserved.