Giglio Mariano Cesare, Persico Marcello, Quarto Gennaro, Benassai Giacomo, Luglio Gaetano, Tarquini Rachele, Celentano Valerio, Sollazzo Viviana, Bucci Luigi
Ann Ital Chir. 2013 May-Jun;84(3):287-90.
Aim of this study is to evaluate the presence of fecal incontince and its impact on life-quality after intersphincteric resection for low rectal cancer.
Twentyeight patients (18 males and 10 female) underwent intersphincteric resection for low rectal cancer between 2006 and 2008. The presence of fecal incontinence was evaluated by Wexner score pre-operatory and 3, 6 and 12 months after ileostomy closure; Quality of Life was evaluated by Fecal Incontinence Quality Of Life (FIQL) score.
Wexner score was significatively (p<0.01) higher in the post-operative period (14,07 ± 1.94, 13.36 ± 2.3 and 12.29 ± 2.3 at 3.6 and 12 months) than the pre-operative one (0.72 ± 0.71). Post-operative life-quality specifically related to fecal incontince was worse than in the pre-operative period (FIQL: 10.84 ± 2.52 at 12 months vs 16 preoperative period).
Wexner score results show a significative worsening in fecal incontinence after intersphincteric resection, even if this condition seems to improve during the follow-up. These results agree with literature.
Intersphincteric resection for low rectal cancer is associated, in the short term (12 months), with a significative state of fecal incontinence. This state has a significative impact on life-quality. However a longer follow-up probably might show an improvement in life-quality parameters.
本研究旨在评估低位直肠癌行括约肌间切除术后大便失禁的情况及其对生活质量的影响。
2006年至2008年间，28例患者（18例男性，10例女性）接受了低位直肠癌括约肌间切除术。通过韦克斯纳评分在术前、回肠造口关闭后3个月、6个月和12个月评估大便失禁情况；采用大便失禁生活质量（FIQL）评分评估生活质量。
术后各时期（3个月、6个月和12个月时分别为14.07±1.94、13.36±2.3和12.29±2.3）的韦克斯纳评分显著高于术前（0.72±0.71）（p<0.01）。术后与大便失禁相关的生活质量比术前更差（FIQL：12个月时为10.84±2.52，术前为16）。
韦克斯纳评分结果显示括约肌间切除术后大便失禁情况显著恶化，尽管这种情况在随访期间似乎有所改善。这些结果与文献一致。
低位直肠癌括约肌间切除术在短期内（12个月）与显著的大便失禁状态相关。这种状态对生活质量有显著影响。然而，更长时间的随访可能会显示生活质量参数有所改善。
