Engel Jutta, Kerr Jacqueline, Schlesinger-Raab Anne, Eckel Renate, Sauer Hansjörg, Hölzel Dieter
Munich Field Study, Munich Cancer Registry, Klinikum Grobetahadern, Luwig-Maximilians-University, Munich Germany.
Ann Surg. 2003 Aug;238(2):203-13. doi: 10.1097/01.sla.0000080823.38569.b0.
To assess long-term quality of life in a population-based sample of rectal cancer patients.
Quality of life in rectal cancer patients who suffer reduced bowel and sexual function is very important. Few studies, however, have long term follow-up data or sufficient sample sizes for reliable comparisons between operation groups.
A 4-year prospective study of rectal cancer patients' quality of life was assessed by using the European Organization for Research and Treatment of Cancer QLQ-30 and CR38 questionnaires.
A total of 329 patients returned questionnaires. Overall, anterior resection patients had better quality of life scores than abdominoperineal extirpation patients. High-anterior resection patients had significantly better scores than both low-anterior resection and abdominoperineal extirpation patients. Low-anterior resection patients, however, overall had a better quality of life than abdominoperineal extirpation patients, especially after 4 years. Abdominoperineal extirpation patients' quality of life scores did not improve over time. Stoma patients had significantly worse quality of life scores than nonstoma patients. Quality of life improved greatly for patients whose stoma was reversed.
Anterior resection and nonstoma patients, despite suffering micturition and defecation problems, had better quality of life scores than abdominoperineal extirpation and stoma patients. Comparisons between abdominoperineal extirpation and anterior resection patients should consider the effect of temporary stomas. Improvements in quality of life scores over time may be explained by reversal of temporary stomas or physiologic adaptation.
评估基于人群样本的直肠癌患者的长期生活质量。
肠道和性功能减退的直肠癌患者的生活质量非常重要。然而，很少有研究拥有长期随访数据或足够大的样本量来进行手术组之间可靠的比较。
采用欧洲癌症研究与治疗组织QLQ - 30和CR38问卷对直肠癌患者的生活质量进行了为期4年的前瞻性研究。
共有329名患者返回问卷。总体而言，前切除术患者的生活质量得分高于腹会阴联合切除术患者。高位前切除术患者的得分显著高于低位前切除术和腹会阴联合切除术患者。然而，低位前切除术患者总体上比腹会阴联合切除术患者生活质量更好，尤其是在4年后。腹会阴联合切除术患者的生活质量得分并未随时间改善。造口患者的生活质量得分显著低于非造口患者。造口回纳的患者生活质量有很大改善。
前切除术患者和非造口患者，尽管存在排尿和排便问题，但生活质量得分高于腹会阴联合切除术患者和造口患者。腹会阴联合切除术患者和前切除术患者之间的比较应考虑临时造口的影响。生活质量得分随时间的改善可能是由于临时造口的回纳或生理适应。
