Ribeiro Paulo Augusto Ayrosa, Sekula Vanessa Gozzo, Abdalla-Ribeiro Helisabet Salomão, Rodrigues Francisco Cesar, Aoki Tsutomu, Aldrighi José Mendes
Obstetrics and Gynecology Department, Faculdade de Ciências Médica da Santa Casa de São Paulo, Rua Dr Brasilio Machado, 421 apto 07, Sao Paulo, SP, CEP 01230-010, Brazil,
Qual Life Res. 2014 Mar;23(2):639-43. doi: 10.1007/s11136-013-0481-y. Epub 2013 Aug 3.
To evaluate the changes in quality of life (QOL) over a 1-year follow-up period in patients submitted to laparoscopic colorectal resection for the treatment of deep endometriosis.
A prospective observational cohort study (Canadian Task Force Design Classification II) involving 40 women with intestinal deep endometriosis was conducted between June 2007 and September 2008 at the Department of Obstetrics and Gynecology, Santa Casa Medical School, Sao Paulo, Brazil. Prior to the surgical procedure, all patients received magnetic resonance studies of the pelvis and rectal echoendoscopy, which suggested intestinal involvement of the disease in all cases. The patients received laparoscopic colorectal resections and treatment for other endometriotic lesions. The subjects completed the QOL SF-36 at 3 time points (T0 pre-operatively; T1 6 months post-operatively; and T2 1 year post-operatively).
The physical functioning, role physical, social functioning and role emotional subscales evidenced the most substantial median increases for T0, T1 and T2. The pain, general health, vitality and mental health domains showed slight changes and increases in medians but did not increase to the same extent as the previous group. Significant improvements were observed in all domains of the SF-36 throughout the study period (p < 0.05). Physical health-related QOL domains showed greater improvement than mental health domains. Analyses of age, parity and body mass index as potential factors influencing the impact of surgery on QOL revealed no differences. Therefore, these factors were not used as prognostic indicators for the surgical procedure or for patient follow-up. In addition, we noted that the patients with poorest results on the initial QOL questionnaire showed the greatest improvements at the end point.
The study results showed that laparoscopic colorectal segment resection for endometriosis had a positive impact on QOL in this patient group. The positive effects persisted 1 year after surgery.
评估接受腹腔镜结直肠切除术治疗深部子宫内膜异位症的患者在1年随访期内生活质量（QOL）的变化。
2007年6月至2008年9月，在巴西圣保罗圣卡塔琳娜医学院妇产科进行了一项前瞻性观察队列研究（加拿大工作组设计分类II），纳入40例肠道深部子宫内膜异位症女性患者。手术前，所有患者均接受盆腔磁共振检查和直肠超声内镜检查，所有病例均提示疾病累及肠道。患者接受腹腔镜结直肠切除术及其他子宫内膜异位病变的治疗。受试者在3个时间点（T0术前；T1术后6个月；T2术后1年）完成QOL SF-36问卷。
身体功能、角色身体、社会功能和角色情感分量表显示，T0、T1和T2的中位数增加最为显著。疼痛、总体健康、活力和心理健康领域有轻微变化，中位数有所增加，但增幅不如前一组。在整个研究期间，SF-36的所有领域均观察到显著改善（p<0.05）。与身体健康相关的QOL领域的改善大于心理健康领域。对年龄、产次和体重指数作为影响手术对QOL影响的潜在因素进行分析，未发现差异。因此，这些因素未被用作手术或患者随访的预后指标。此外，我们注意到，初始QOL问卷结果最差的患者在终点时改善最大。
研究结果表明，腹腔镜结直肠节段切除术治疗子宫内膜异位症对该患者群体的QOL有积极影响。积极效果在术后1年持续存在。
