McCarthy A S E, Solomon M J, Koh C E, Firouzbakht A, Jackson S A, Steffens D
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Colorectal Dis. 2020 May;22(5):521-528. doi: 10.1111/codi.14925. Epub 2020 Jan 5.
The aim was to compare postoperative quality of life (QOL) between patients undergoing pelvic exenteration (PE) and pelvic exenteration with sacrectomy (PES), and to investigate the influence of high (L5-S2) vs low (≤ S3) sacrectomy on QOL and functional outcomes.
Patients undergoing en bloc sacrectomy as part of a PE and PE alone from 2008 to 2015 were identified from a prospectively maintained database. QOL and functional outcomes were assessed using the 36-Item Short Form Survey, the European Organization for Research and Treatment of Cancer Colorectal Cancer questionnaire and Quality of Life questionnaire, the Revised Musculoskeletal Tumour Scale, the Lower Extremity Functional Scale, the Sexual Health Inventory for Men and the Female Sexual Function Index.
Of the 344 patients identified, data were available for 116 patients who underwent PE alone and 140 patients who underwent PES. PES patients had significantly poorer physical component scores (P < 0.001) but not mental component scores (P = 0.17). Of the 140 PES patients, 55 were eligible and were invited to participate in a second functional survey, with 30 patients returning the study questionnaire. High sacrectomy patients, compared with low sacrectomy, had significantly worse lower limb motor function (P = 0.03) and poorer physical (P = 0.001) and mental health component scores (P = 0.02). No differences were found in sexual, bladder and bowel function between high and low sacrectomy patients.
Patients undergoing PES had worse physical component scores compared with PE alone, whereas high sacrectomy patients had significantly worse lower limb motor function and physical and mental component scores but comparable bowel, bladder and sexual functional outcomes compared with low sacrectomy patients.
比较盆腔脏器清扫术（PE）患者与盆腔脏器清扫联合骶骨切除术（PES）患者术后的生活质量（QOL），并研究高位（L5-S2）与低位（≤S3）骶骨切除术对生活质量和功能结局的影响。
从一个前瞻性维护的数据库中识别出2008年至2015年期间接受整块骶骨切除术作为PE一部分的患者以及仅接受PE的患者。使用36项简短调查问卷、欧洲癌症研究与治疗组织结直肠癌问卷和生活质量问卷、修订的肌肉骨骼肿瘤量表、下肢功能量表、男性性健康量表和女性性功能指数评估生活质量和功能结局。
在识别出的344例患者中，有116例仅接受PE的患者和140例接受PES的患者有可用数据。PES患者的身体成分得分明显较差（P<0.001），但心理成分得分无差异（P=0.17）。在140例PES患者中，55例符合条件并被邀请参加第二次功能调查，其中30例患者返回了研究问卷。与低位骶骨切除术患者相比，高位骶骨切除术患者的下肢运动功能明显更差（P=0.03），身体（P=0.001）和心理健康成分得分更差（P=0.02）。高位和低位骶骨切除术患者在性功能、膀胱和肠道功能方面未发现差异。
与仅接受PE的患者相比，接受PES的患者身体成分得分更差，而与低位骶骨切除术患者相比，高位骶骨切除术患者的下肢运动功能、身体和心理成分得分明显更差，但肠道、膀胱和性功能结局相当。
