Fucini C, Gattai R, Urena C, Bandettini L, Elbetti C
Department of Medical and Surgical Critical Care, Section of General and Oncological Surgery, University of Florence, Viale Morgagni, 85, 50134, Firenze, Italy.
Ann Surg Oncol. 2008 Apr;15(4):1099-106. doi: 10.1245/s10434-007-9748-2. Epub 2008 Jan 8.
Low rectal cancers situated less than 5 cm from the anal margin are still usually treated with abdomino-perineal excision (APE). Our aim is to compare the quality of life (QOL) of five-year survivors treated for low or very low rectal cancer with an advanced/complex coloanal procedure with the QOL of patients submitted to a standard APE with a definitive abdominal stoma.
Sixty-two patients, operated on radically for low or very low rectal cancer, who came for their fifth year follow-up visit and were free from cancer, were studied. Thirty patients (group 1) had an APE with permanent abdominal stoma. Thirty-two patients (group 2) had undergone a radical advanced and complex procedure to avoid the abdominal stoma. The patients received the European Organisation for the Research and Treatment of Cancer (EORTC) QOL-30 generic and the CR38 colorectal cancer QOL questionnaires with the recommendation to return the questionnaire to the hospital. The Mann-Whitney U-test and chi (2) Fisher test were employed for statistical analysis.
All questionnaires were returned. Patients without a terminal abdominal stoma had a better score in six categories of the QOL 30 and in two categories of the CR38. No differences were observed in the other variables examined.
After five years, cancer-free patients operated on for low or very low rectal cancer have a better QOL if a definitive terminal abdominal stoma was avoided.
距肛缘小于5 cm的低位直肠癌通常仍采用腹会阴联合切除术（APE）治疗。我们的目的是比较采用先进/复杂结肠肛管手术治疗低位或极低位直肠癌的五年生存者的生活质量（QOL）与接受标准APE并带有永久性腹部造口的患者的生活质量。
研究了62例因低位或极低位直肠癌接受根治性手术、前来进行第五年随访且无癌症的患者。30例患者（第1组）接受了带有永久性腹部造口的APE。32例患者（第2组）接受了根治性的先进复杂手术以避免腹部造口。患者接受了欧洲癌症研究与治疗组织（EORTC）的QOL - 30通用问卷和CR38结直肠癌QOL问卷，并被建议将问卷返回医院。采用Mann - Whitney U检验和卡方（2）Fisher检验进行统计分析。
所有问卷均已返回。没有末端腹部造口的患者在QOL 30的六个类别和CR38的两个类别中得分更高。在检查的其他变量中未观察到差异。
五年后，对于低位或极低位直肠癌接受手术且无癌症的患者，如果避免了永久性末端腹部造口，其生活质量会更好。
