Division of General Surgery, Caritas St. Elizabeth's Medical Center, Boston, Massachusetts 02135, USA.
Dis Colon Rectum. 2011 May;54(5):615-21. doi: 10.1007/DCR.0b013e318207f85f.
When a patient is deciding between treatment options for localized prostate cancer, brachytherapy is commonly chosen for its perceived low complication profile. Brachytherapy can frequently be complicated by the development of fecal incontinence. The potential long-term impact of this dysfunction on a patient's life should be discussed.
This study aimed to assess the long-term impact of brachytherapy for localized prostate cancer on fecal incontinence and to determine the impact and severity of the incontinence on patients' ability to engage in activities of daily living.
A retrospective observational study was performed. A questionnaire packet was mailed to patients who had received brachytherapy treatment for localized prostate cancer and were now more than 2 years out from initial seed implantation. Each packet contained the Colon and Ano-Rectal Impact Questionnaire (assessing quality of life), the Colon and Ano-Rectal Distress Inventory, and the Cleveland Clinic Fecal Incontinence Score (both measured existence and severity of fecal incontinence).
This study was conducted at Caritas Christi St. Elizabeth's Medical Center, a tertiary referral center in Boston, Massachusetts from January 1, 1998 to December 31, 2007.
One hundred forty-three of 568 patients (a 25% response rate) responded and were analyzed.
No interventions were performed.
The main outcome was impact of fecal incontinence on quality of life.
: Of the responses to the Colon and Ano-Rectal Impact Questionnaire, 13.2% (19 patients) (P < .001) stated that fecal incontinence was impacting their ability to participate in their daily activities. Sixty-three percent (12 patients) (P < .001) of patients described the impact of the incontinence as slight, 21% (4 patients) (P < .001) described it as moderate, and 15.8% (3 patients) (P < .001) described it as severe.
There were no case-matched controls and the response rate to the surveys was low.
Postbrachytherapy fecal incontinence leaves a long-term impact on patients' ability to engage in activities of daily living.
当患者在选择局限性前列腺癌的治疗方案时，由于其并发症发生率低，近距离放射治疗通常是首选。近距离放射治疗常因大便失禁而变得复杂。这种功能障碍对患者生活的潜在长期影响应予以讨论。
本研究旨在评估局限性前列腺癌近距离放射治疗后对大便失禁的长期影响，并确定失禁对患者日常生活活动能力的影响和严重程度。
回顾性观察性研究。向接受过近距离放射治疗局限性前列腺癌且距初始种子植入超过 2 年的患者邮寄了一份问卷包。每个包裹都包含了结肠和肛门直肠影响问卷（评估生活质量）、结肠和肛门直肠不适量表以及克利夫兰诊所粪便失禁评分（均测量粪便失禁的存在和严重程度）。
这项研究是在马萨诸塞州波士顿的三级转诊中心 Caritas Christi St.Elizabeth's Medical Center 进行的，时间为 1998 年 1 月 1 日至 2007 年 12 月 31 日。
568 例患者中有 143 例（25%的应答率）作出回应并进行了分析。
未进行干预。
主要观察指标为大便失禁对生活质量的影响。
在对结肠和肛门直肠影响问卷的回应中，有 13.2%（19 例）（P <.001）表示大便失禁影响了他们参与日常活动的能力。63%（12 例）（P <.001）的患者将失禁的影响描述为轻微，21%（4 例）（P <.001）描述为中度，15.8%（3 例）（P <.001）描述为严重。
没有病例匹配的对照组，且调查的回应率很低。
近距离放射治疗后大便失禁会对患者的日常生活活动能力产生长期影响。
