QUALITY-OF-LIFE IN COLORECTAL-CANCER - STOMA VS NONSTOMA PATIENTS
QUALITY-OF-LIFE IN COLORECTAL-CANCER - STOMA VS NONSTOMA PATIENTS
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DOI：
10.1007/bf02054222
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发表时间：
1995-04-01
影响因子：
3.9
通讯作者：
TEVELDE, A
中科院分区：
文献类型：
--
作者：
SPRANGERS, MAG;TAAL, BG;TEVELDE, A
目得：结肠直肠癌患者接受保肛或牺牲括约肌手术可能会损害其肠功能和性功能。一个合理的问题是这些不同的手术技术如何影响患者的生活质量。方法：确定了17项研究，比较了患者功能的四个方面中的至少一个（即，生理、心理、社会和性）之间的差异。研究结果：虽然文献没有得出完全一致的结果，但可以确定手术的一些长期影响：1）两组患者都受到频繁或不规则排便和腹泻的困扰; 2）造口患者报告的心理困扰水平高于非造口患者; 3）尽管造口患者和非造口患者都报告了他们的社会功能水平的限制，这些问题在结肠造口患者中更普遍; 4）男性和女性造口患者的性功能始终比括约肌完整的男性和女性患者的性功能更受损。目前的审查结果与其他相关领域的审查结果进行了比较。结论：虽然非造口患者通常比造口患者更好，但他们也患有由括约肌保留手术引起的身体损伤（例如，肠功能和性功能受损）。随着超低吻合术的应用越来越频繁，这些损伤可能变得越来越普遍，导致肠道和性功能障碍以及相关的心理困扰。需要设计良好的研究来检查与结肠造口术相比，使用超低吻合术是否能获得生活质量方面的益处。
PURPOSE: The bowel and sexual function of colorectal cancer patients undergoing either sphincter-saving or sphincter-sacrificing surgical procedures may be impaired. A legitimate question is how these different surgical techniques affect the patients' quality of life. METHODS: Seventeen studies were identified that compared at least one of four aspects of patient functioning (i.e., physical, psychologic, social, and sexual) between stoma patients and nonstoma patients. RESULTS: Although the literature does not yield entirely consistent findings, some long-term effects of surgery can be identified: 1) both patient groups are troubled by frequent or irregular bowel movements and diarrhea; 2) stoma patients report higher levels of psychologic distress than do nonstoma patients; 3) although both stoma patients and nonstoma patients report restrictions in their level of social functioning, such problems are more prevalent among patients With a colostomy; 4) sexual functioning of male and female stoma patients is consistently more impaired than that of male and female patients with intact sphincters. Results of the current review were compared with those of other, related areas. CONCLUSIONS: Although nonstoma patients generally fare better than do stoma patients, they also suffer from physical impairments induced by sphincter-saving procedures (e.g., impaired bowel and sexual function). These impairments may become more prevalent as ultralow anastomosis is more frequently applied, resulting in bowel and sexual dysfunction and related psychologic distress. Well-designed studies are needed that examine whether quality-of-life benefits are to be gained by use of ultralow anastomosis compared with colostomy.