Hara Isao, Kawabata Gaku, Miyake Hideaki, Nakamura Ichiro, Hara Shoji, Okada Hiroshi, Kamidono Sadao
Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
J Urol. 2003 Jun;169(6):2045-8. doi: 10.1097/01.ju.0000063961.99940.6c.
We compare the quality of life after laparoscopic prostatectomy to that after standard radical prostatectomy.
The quality of life of 52 and 54 patients who underwent laparoscopic and open radical prostatectomy, respectively, was analyzed using the European Organization for the Research and Treatment of Cancer Prostate Cancer quality of life questionnaire for general health related quality of life, International Index of Erectile Function 5 for screening erectile dysfunction and International Continence Society MaleSF questionnaire to evaluate urinary status. These questionnaires were given to patients before and 6 months after surgery.
The general health related quality of life survey revealed no significant differences in health before and after laparoscopic and open prostatectomy. However, sexual quality of life was markedly lower after surgery (p <0.01). In addition, the International Index of Erectile Function score was markedly abrogated by surgery (p <0.05) and quality of life due to urinary incontinence was significantly disturbed by surgery (p <0.05). In contrast, quality of life due to voiding dysfunction was impaired before surgery and significantly improved by surgery (p <0.05). Patients were also asked if they would choose the same treatment if suffering from the same disease, with more patients treated laparoscopically choosing the same treatment than those treated with open surgery (p <0.05).
While general health related quality of life was not impaired, sexual quality of life was diminished by surgery. Patients were generally satisfied with postoperative urinary status. Although patients who underwent laparoscopic prostatectomy expressed a more favorable attitude toward surgery, there was no significant difference in quality of life at 6 months after surgery between the 2 groups.
比较腹腔镜前列腺切除术后与标准根治性前列腺切除术后的生活质量。
分别对52例接受腹腔镜根治性前列腺切除术和54例接受开放性根治性前列腺切除术的患者,使用欧洲癌症研究与治疗组织前列腺癌生活质量问卷来分析与总体健康相关的生活质量,使用国际勃起功能指数5来筛查勃起功能障碍,并使用国际尿控协会男性性功能问卷来评估排尿状况。这些问卷在手术前和手术后6个月发给患者。
与总体健康相关的生活质量调查显示,腹腔镜和开放性前列腺切除术前、后的健康状况无显著差异。然而,术后性功能生活质量明显较低(p<0.01)。此外,手术明显降低了国际勃起功能指数评分(p<0.05),手术导致的尿失禁对生活质量有显著影响(p<0.05)。相比之下,术前排尿功能障碍导致的生活质量受损,而手术使其显著改善(p<0.05)。还询问了患者如果患有相同疾病是否会选择相同的治疗方法,接受腹腔镜手术治疗的患者中选择相同治疗方法的比接受开放手术治疗的患者更多(p<0.05)。
虽然与总体健康相关的生活质量未受损,但手术降低了性功能生活质量。患者总体上对术后排尿状况满意。尽管接受腹腔镜前列腺切除术的患者对手术的态度更积极,但两组术后6个月的生活质量无显著差异。