Long-term functional follow-up after anterior rectal resection for cancer
Long-term functional follow-up after anterior rectal resection for cancer
复制标题
DOI：
10.1007/s00384-016-2659-6
复制
发表时间：
2017-01-01
影响因子：
2.8
通讯作者：
Valeri, Andrea
中科院分区：
文献类型：
--
作者：
Sturiale, Alessandro;Martellucci, Jacopo;Valeri, Andrea
这是一项回顾性分析，包括1998年1月至2005年12月在两个三级转诊中心接受直肠癌前切除术的所有患者。本研究的目的是评估低位前切除术后的长期功能结果，并确定术后肠道疾病的危险因素，数据收集自临床记录，然后向选定的患者提交低位前切除术综合征评分，这是一份专门调查术后症状的问卷。排除标准包括腹腔内直肠癌、部分直肠系膜切除术、永久性造口、局部复发性疾病和拒绝手术的患者。中位随访时间为13.7年，44例患者（47.5%）报告了低位前切除综合征，19例患者（20.5%）有主要表现，25例患者（27%）有轻微症状。年龄> 70岁、肿瘤距肛门外缘距离、新辅助治疗、吻合口关闭间隔时间是影响术后功能障碍的独立预后因素，对患者的生活质量影响较大，应早期发现综合征，尽量减少其表现。此外，症状似乎在手术后1年保持稳定;因此，重要的是要有一个详尽的，术前咨询和综合术后功能和康复随访与肿瘤途径。
This is a retrospective analysis including all of the patients that have undergone anterior resection for rectal cancer from January 1998 to December 2005 in two tertiary referral centers. The study aims to evaluate the long term functional results after low anterior resection and to identify the risk factors of postoperative bowel disorders.Data were collected from the clinical records, and then the low anterior resection syndrome score which is a specific questionnaire to investigate the symptoms after surgery was submitted to the selected patients. Exclusion criteria were intra-abdominal rectal cancer, partial mesorectal excision, permanent stoma, recurrent local disease, and patients who declined the questionnaire.A total of 93 patients were included in the analysis with a median age at the diagnosis of 66 years. The median follow-up was 13.7 years, and low anterior resection syndrome was reported in 44 patients (47.5 %), with major manifestations in 19 patients (20.5 %), and minor symptoms in 25 patients (27 %). Age more than 70 years, tumor distance from the external anal verge, neoadjuvant treatment, and interval time of closing stoma are independent prognostic factors of functional disorders after surgery.Because of its great impact on the quality of life of these patients, it is necessary to early identify the syndrome trying to reduce its manifestations. Moreover, the symptoms seem to remain stable 1 year after surgery; hence, it is important to have an exhaustive, preoperative counseling and an integrated post-operative functional and rehabilitational follow-up in association with the oncologic pathway.