Farroni Nadia, Van den Bosch Anita, Haustermans Karin, Van Cutsem Eric, Moons Philip, D'hoore André, Penninckx Freddy
Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium.
Dis Colon Rectum. 2007 Jun;50(6):817-24. doi: 10.1007/s10350-007-0229-2.
Abdominoperineal rectum resection with perineal colostomy and appendicostomy for antegrade continence enema has been developed as an alternative for abdominal colostomy or total anal reconstruction in patients with low rectal cancer. This present study was designed to compare symptoms, functional status, quality of life, and perceived health after perineal colostomy and appendicostomy with that after abdominal colostomy.
Twenty-seven patients, 14 with abdominal colostomy and 13 with perineal colostomy and appendicostomy, were included. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires C30 and CR38 were used to investigate functional status and symptoms. Quality of life was measured by using a Linear Analog Scale and the Satisfaction with Life Scale. Self-perceived health was assessed by using a Linear Analog Scale.
Patients with perineal colostomy and appendicostomy were younger and more frequently female. They experienced better physical functioning (93.3 vs. 73.3 P = 0.048), a slightly better role functioning (100 vs. 83.3 not significant), body image (77.8 vs. 66.7 not significant), and sexual functioning (33.3 vs. 0; not significant) than patients with abdominal colostomy. Stoma-related problems were substantial in patients with abdominal colostomy (38.1) and very limited in patients with an appendicostomy (8.7). Fecal loss did not occur one hour or more after antegrade continence enema in 11 patients with perineal colostomy and was limited in the others. Quality of life and self-perceived health were comparably good in both groups.
Perineal colostomy with appendicostomy for antegrade continence enema is a valid and acceptable alternative for a permanent abdominal colostomy in selected patients, with a comparable functional and quality of life outcome.
经腹会阴直肠切除术加会阴结肠造口术及阑尾造口术用于顺行性节制灌肠，已被开发作为低位直肠癌患者腹部结肠造口术或全肛门重建术的替代方案。本研究旨在比较会阴结肠造口术及阑尾造口术与腹部结肠造口术后的症状、功能状态、生活质量和自我感知健康状况。
纳入27例患者，其中14例行腹部结肠造口术，13例行会阴结肠造口术及阑尾造口术。使用欧洲癌症研究与治疗组织生活质量问卷C30和CR38来调查功能状态和症状。采用线性模拟量表和生活满意度量表测量生活质量。通过线性模拟量表评估自我感知健康状况。
会阴结肠造口术及阑尾造口术患者更年轻，女性更为常见。与腹部结肠造口术患者相比，他们的身体功能更好（93.3对73.3，P = 0.048），角色功能稍好（100对83.3，无统计学意义），身体形象（77.8对66.7，无统计学意义），性功能（33.3对0；无统计学意义）。腹部结肠造口术患者的造口相关问题较多（38.1），而阑尾造口术患者则非常有限（8.7）。11例会阴结肠造口术患者在顺行性节制灌肠后1小时或更长时间未出现粪便失禁，其他患者也有限。两组的生活质量和自我感知健康状况相当良好。
经会阴结肠造口术加阑尾造口术用于顺行性节制灌肠，对于部分患者来说，是永久性腹部结肠造口术的一种有效且可接受的替代方案，其功能和生活质量结果相当。
