Department of Gastroenterological Surgery, St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.
Surg Today. 2011 Sep;41(9):1200-6. doi: 10.1007/s00595-010-4450-6. Epub 2011 Aug 26.
We investigated the functional outcome and health-related quality of life (QOL) of patients who underwent a surgical resection of colorectal cancer, and reviewed the efficacy of probiotics for improving bowel function.
A questionnaire was mailed to 193 patients. Questionnaires contained the Medical Outcomes Study Short-Form 36-Item Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 as QOL scores, the Wexner incontinence score, and original questionnaire items about bowel functions. Probiotics, containing Bacillus natto and Lactobacillus acidophilus, were given to 77 patients for 3 months; after 3 months of treatment, the same questionnaire was administered. The results were analyzed by location of the resected cancer: rectal, colonic, right, and left.
In the rectal group, defecation frequency, anal pain, and the Wexner score were significantly worse than in the colonic group. In the right group, the fecal form was looser and nighttime defecation frequency was higher than those of the left group. Three items in the QOL score of the right group were significantly worse compared with the left group. Functional outcome including defecation frequency, feeling of incomplete defecation, and five items in the QOL score were significantly improved after taking probiotics. Improvement in functional outcome and/or QOL was observed in all groups.
Not only rectal resection but also rightside colectomy affected bowel dysfunction. Probiotics could be an effective treatment for improvement in functional outcome and QOL after colorectal resection.
我们调查了接受结直肠肿瘤切除术患者的功能结果和健康相关生活质量（QOL），并回顾了益生菌改善肠道功能的疗效。
我们向 193 名患者邮寄了问卷。问卷包含医疗结局研究简表 36 项健康调查和欧洲癌症研究与治疗组织生活质量问卷 C30 作为 QOL 评分、Wexner 失禁评分以及关于肠道功能的原始问卷项目。77 名患者服用了含有纳豆芽孢杆菌和嗜酸乳杆菌的益生菌，治疗 3 个月后，再次进行了相同的问卷调查。分析结果时按切除肿瘤的部位进行：直肠、结肠、右半结肠和左半结肠。
在直肠组中，排便频率、肛门疼痛和 Wexner 评分明显差于结肠组。在右半结肠组中，粪便形态较稀，夜间排便频率高于左半结肠组。右半结肠组的 QOL 评分中有 3 项明显差于左半结肠组。服用益生菌后，右半结肠组的排便频率、排便不尽感以及 QOL 评分中的 5 项功能结果明显改善。所有组的功能结果和/或 QOL 均有改善。
不仅直肠切除术，右半结肠切除术也会影响肠道功能。益生菌可能是改善结直肠切除术后功能结果和 QOL 的有效治疗方法。
