First Surgical Clinic, Clinical Centre of Serbia, Belgrade, Serbia College for Sport and Health, Belgrade, Serbia.
Colorectal Dis. 2011 Jun;13(6):638-43. doi: 10.1111/j.1463-1318.2010.02244.x. Epub 2010 Feb 20.
The aim of the study was to investigate function and quality of life after different types of intersphincteric resection (ISR).
Between January 2006 and February 2008, 45 patients (34 men and 11 women) with distal third rectal cancer underwent curative ISR. Function was evaluated using the Memorial Sloan Kettering Cancer Center bowel function questionnaire and Wexner score, anal manometry and measurements of rectal capacity were also performed. Quality of life was assessed using the Serbian version of the European Organisation for Research and Treatment of Cancer, quality of life questionnaire (EORTC QLQ-C30) and the translated version of the fecal incontinence quality of life scale (FIQL).
There were no postoperative deaths. Partial ISR was performed in 22 (48.9%) patients, subtotal ISR was performed in 19 (42.2%) patients and total ISR was performed in four (8.9%) patients. Anastomotic leakage occurred in nine (20%) patients. Five (11.1%) of 45 patients had major (complete) incontinence and a further six (13.3%) patients had continuing frequent faecal leakage 12 months after ileostomy reversal. There was no significant difference in quality of life between the groups in the EORTC QLQ-C30 scale, but this was significantly altered by internal anal sphincter resection in two of the FIQL scales (coping/behaviour and depression/self-perception).
Although ISR does not affect quality of life in general, the extent of internal anal sphincter resection has a negative impact on symptom-specific quality of life owing to faecal incontinence.
本研究旨在探讨不同类型经肛门括约肌间切除术（ISR）的功能和生活质量。
2006 年 1 月至 2008 年 2 月，45 例低位直肠癌患者（34 名男性，11 名女性）接受了根治性 ISR 手术。采用纪念斯隆凯特琳癌症中心（Memorial Sloan Kettering Cancer Center）肠道功能问卷和 Wexner 评分评估功能，还进行了肛门测压和直肠容量测量。采用欧洲癌症研究与治疗组织（European Organisation for Research and Treatment of Cancer，EORTC）生活质量问卷（Quality of Life Questionnaire，QLQ-C30）和粪便失禁生活质量量表（Fecal Incontinence Quality of Life Scale，FIQL）的塞尔维亚语版本评估生活质量。
术后无死亡病例。22 例（48.9%）患者行部分 ISR，19 例（42.2%）患者行次全 ISR，4 例（8.9%）患者行全 ISR。9 例（20%）患者发生吻合口漏。45 例患者中，5 例（11.1%）发生完全性失禁，另有 6 例（13.3%）患者在回肠造口还纳后 12 个月仍有频繁粪便渗漏。EORTC QLQ-C30 量表中各组间生活质量无显著差异，但 FIQL 量表中的两项（应对/行为和抑郁/自我认知）因内括约肌切除程度而显著改变。
尽管 ISR 总体上不影响生活质量，但内括约肌切除范围对粪便失禁导致的特定症状的生活质量有负面影响。
