Menteş B Bülent, Tezcaner Tugan, Yilmaz Utku, Leventoğlu Sezai, Oguz Mehmet
Department of Surgery, Colorectal Surgery Unit, Gazi University Medical School, Ankara, Turkey.
Dis Colon Rectum. 2006 Jul;49(7):1045-51. doi: 10.1007/s10350-006-0527-0.
The aim of this study was to investigate the effects of lateral internal sphincterotomy on quality of life in patients with chronic anal fissure using the Gastrointestinal Quality of Life Index and the Fecal Incontinence Quality of Life Scale.
Adult patients with chronic anal fissure underwent lateral internal sphincterotomy with the open technique. Two hundred forty-four patients completed the Gastrointestinal Quality of Life Index questionnaire at admission and at 12 months postoperatively. The Fecal Incontinence Severity Index score was calculated preoperatively and at 2 and 12 months postoperatively. The Fecal Incontinence Quality of Life Scale was administered to any patient who had a Fecal Incontinence Severity Index score greater than 0 at 12 months postoperatively.
The mean preoperative Gastrointestinal Quality of Life Index score was 118.34 +/- 6.33, which developed to 140.74 +/- 2.38 postoperatively (P< 0.001). At the two-month follow-up, 18 patients (7.38 percent) had a Fecal Incontinence Severity Index score greater than 0. By 12 months, the number of patients with Fecal Incontinence Severity Index score greater than 0 was reduced to seven (2.87 percent). These seven patients had a Gastrointestinal Quality of Life Index score similar to that of the group with postoperative Fecal Incontinence Severity Index score of 0, and only three patients (1.22 percent) had evident deterioration in the Fecal Incontinence Quality of Life Scale. The 12-month total Gastrointestinal Quality of Life Index score of the three patients who developed anal abscess/fistula after sphincterotomy (139.33 +/- 3.21) was similar to the Gastrointestinal Quality of Life Index score of those without complications. However, the Gastrointestinal Quality of Life Index score of the recurrent cases (111.53 +/- 3.53) was apparently low.
The gastrointestinal quality of life improved significantly following lateral internal sphincterotomy, regardless of the surgical complications or postoperative disturbances of continence. Only 1.2 percent of the patients experienced deterioration in Fecal Incontinence Quality of Life Scale.
本研究旨在使用胃肠道生活质量指数和大便失禁生活质量量表，调查侧方内括约肌切开术对慢性肛裂患者生活质量的影响。
成年慢性肛裂患者采用开放技术接受侧方内括约肌切开术。244例患者在入院时及术后12个月完成了胃肠道生活质量指数问卷。在术前、术后2个月和12个月计算大便失禁严重程度指数评分。对术后12个月大便失禁严重程度指数评分大于0的任何患者进行大便失禁生活质量量表评估。
术前胃肠道生活质量指数平均评分为118.34±6.33，术后升至140.74±2.38（P<0.001）。在两个月的随访中，18例患者（7.38%）大便失禁严重程度指数评分大于0。到12个月时，大便失禁严重程度指数评分大于0的患者数量减少至7例（2.87%）。这7例患者的胃肠道生活质量指数评分与术后大便失禁严重程度指数评分为0的组相似，只有3例患者（1.22%）在大便失禁生活质量量表中有明显恶化。括约肌切开术后发生肛门脓肿/肛瘘的3例患者的12个月总胃肠道生活质量指数评分（139.33±3.21）与无并发症患者的胃肠道生活质量指数评分相似。然而，复发病例的胃肠道生活质量指数评分（111.53±3.53）明显较低。
侧方内括约肌切开术后胃肠道生活质量显著改善，无论手术并发症或术后控便障碍如何。只有1.2%的患者在大便失禁生活质量量表中有恶化情况。
