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接受腹腔镜治疗肠道子宫内膜异位症的女性生活质量的长期结果

Long-term outcomes on quality of life in women submitted to laparoscopic treatment for bowel endometriosis.

作者信息

Silveira da Cunha Araújo Raquel, Abdalla Ayroza Ribeiro Helizabet Salomão, Sekula Vanessa Gozzo, da Costa Porto Beatriz Taliberti, Ayroza Galvão Ribeiro Paulo Augusto

机构信息

Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil.

Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil.

出版信息

J Minim Invasive Gynecol. 2014 Jul-Aug;21(4):682-8. doi: 10.1016/j.jmig.2014.02.005. Epub 2014 Feb 13.

Abstract

STUDY OBJECTIVE

To evaluate the long-term effects of laparoscopic surgery on quality of life in women with bowel endometriosis.

DESIGN

Observational prospective cohort study (Canadian Task Force classification II).

SETTING

Central Hospital of Santa Casa, Sao Paulo, Brazil.

PATIENTS

Forty-five patients answered a short-form, 36-item, quality-of-life questionnaire (SF-36) at 3 different times.

INTERVENTIONS

Between June 2007 and September 2008, patients underwent laparoscopic surgery to treat deep infiltrative endometriosis, with colorectal resection.

MEASUREMENTS AND MAIN RESULTS

Forty-five patients with bowel endometriosis were followed up from 2007 to 2012. Before surgery, all patients exhibited signs suggestive of bowel endometriosis at magnetic resonance imaging and transrectal ultrasound. The patients underwent laparoscopic surgery for resection of the endometriosis lesions, including colorectal resection. The patients completed the questionnaire before surgery (T0), at 12 (T12) and 48 (T48) months after surgery. The 8 items of the SF-36 questionnaire at the different time points of application were compared. For each domain attribute, a score of 0 to 100 was assigned, where 0 signified the worst quality of life, and 100 the best. Statistical analysis was performed using analysis of variance. If differences were detected, multiple comparisons were performed using the Tukey test. Analysis of each domain revealed improved quality of life when comparing the period before surgery with 12 and 48 months after surgery. There was a significant increase (p < .001) in the scores in all of the SF-36 domains when comparing T0 vs T12 and T0 vs T48, with higher average scores at T48 corresponding to the domains of physical functioning, role physical, and social functioning (scores of 85.56, 75.69, and 73.61, respectively).

CONCLUSION

Laparoscopic treatment of bowel endometriosis improved the long-term quality of life of patients.

摘要

研究目的

评估腹腔镜手术对肠道子宫内膜异位症女性生活质量的长期影响。

设计

观察性前瞻性队列研究(加拿大工作组分类II级)。

地点

巴西圣保罗圣卡塔琳娜中央医院。

患者

45名患者在3个不同时间点回答了一份36项简短生活质量问卷(SF - 36)。

干预措施

2007年6月至2008年9月期间,患者接受腹腔镜手术治疗深部浸润性子宫内膜异位症,并进行结肠切除术。

测量指标及主要结果

45例肠道子宫内膜异位症患者于2007年至2012年接受随访。手术前,所有患者在磁共振成像和经直肠超声检查中均表现出提示肠道子宫内膜异位症的迹象。患者接受了腹腔镜手术以切除子宫内膜异位症病灶,包括结肠切除术。患者在手术前(T0)、术后12个月(T12)和48个月(T48)完成问卷。比较了SF - 36问卷在不同应用时间点的8个项目。对于每个领域属性,给予0至100分,其中0分表示最差生活质量,100分表示最佳生活质量。采用方差分析进行统计分析。如果检测到差异,则使用Tukey检验进行多重比较。对每个领域的分析显示,将手术前时期与术后12个月和48个月进行比较时,生活质量有所改善。比较T0与T12以及T0与T48时,SF - 36所有领域的得分均显著增加(p <.001),T48时身体功能、角色身体和社会功能领域的平均得分更高(分别为85.56、75.69和73.61分)。

结论

腹腔镜治疗肠道子宫内膜异位症可改善患者的长期生活质量。

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