Jensen Martin Bach, Nørager Charlotte Buchard, Sommer Thorbjorn, Madsen Mogens R, Laurberg Soren
Pol Przegl Chir. 2014 Feb;86(2):82-8. doi: 10.2478/pjs-2014-0015.
The aim of the study was to describe changes in postoperative fatigue, quality of life, physical performance, and body composition in patients undergoing laparoscopic colonic cancer surgery.
In a follow-up study from 2009-2011 at two regional hospitals in Denmark we examined 62 patients having a right hemicolectomy ora sigmoid resection performed. The main outcome measures were fatigue level subjectively scored from 1 ("fit") to 10 ("fatigued") on a modified visual analogue scale and by objective measurements of hand grip and knee extension strength, work capacity, weight, and lean body mass. Quality of life was assessed using the SF-36 questionnaire and pain using an ordinal scale. Patients were examined preoperatively, 1-2 and 4 weeks postoperatively.
Eight patients (13%) were converted to open surgery and the median bleeding (95% confidence interval of the median) was 75 (50-100) ml. One to two weeks after surgery the fatigue level and pain when moving had increased significantly (p=0.0011 and p=0.0002 respectively) and the SF-36 physical component quality of life score decreased (p<0.0001) when compared to preoperatively. However, at 4 weeks postoperatively fatigue level, pain, and quality of life scores were at the preoperative level. There were no significant changes from preoperatively to postoperatively in any of the measures of physical performance, whereas there was a slight reduction in weight and lean body mass after the operation. CONCLUSIONS. Laparoscopic colonic cancer surgery was associated with a short lasting increased fatigue and pain and reduced quality of life, but no significant reduction in physical performance after surgery.
本研究旨在描述接受腹腔镜结肠癌手术患者术后疲劳、生活质量、身体机能及身体成分的变化。
在丹麦两家地区医院进行的一项2009年至2011年的随访研究中，我们检查了62例行右半结肠切除术或乙状结肠切除术的患者。主要结局指标包括：通过改良视觉模拟量表主观评分（从1分“健康”到10分“疲劳”）以及对手握力、膝关节伸展力量、工作能力、体重和瘦体重进行客观测量来评估疲劳程度；使用SF - 36问卷评估生活质量，使用序数量表评估疼痛程度。患者在术前、术后1 - 2周和4周接受检查。
8例患者（13%）转为开放手术，中位出血量（中位值的95%置信区间）为75（50 - 100）毫升。与术前相比，术后1 - 2周疲劳程度和活动时疼痛显著增加（分别为p = 0.0011和p = 0.0002），SF - 36身体成分生活质量评分降低（p < 0.0001）。然而，术后4周时疲劳程度、疼痛和生活质量评分恢复到术前水平。身体机能的各项测量指标从术前到术后均无显著变化，而术后体重和瘦体重略有下降。结论：腹腔镜结肠癌手术与短期疲劳和疼痛增加以及生活质量降低相关，但术后身体机能无显著下降。
