经肛门内镜微创手术（TEMS）治疗直肠癌：患者决策、术后体验和生活质量。
Transanal Endoscopic Microsurgery (TEMS) for Rectal Cancer: Patient Decision-making, Postoperative Experience and Quality of Life.
机构信息
Medical School, University of Crete, Heraklion, Greece;
Nursing Department, University of West Attica, Athens, Greece.
出版信息
In Vivo. 2021 Mar-Apr;35(2):1235-1245. doi: 10.21873/invivo.12374.
BACKGROUND/AIM: Transanal endoscopic microsurgery (TEMS) is a form of minimally invasive surgery for selected rectal cancers. The aim of this study was to explore the factors affecting patients' decision-making concerning the choice of surgical treatment as well as to measure the Quality of Life (QoL) post-TEMS.
PATIENTS AND METHODS
Thirty-four patients with rectal cancer stage T1/T2-N0-M0 that underwent TEMS were studied. The questionnaires used included the Short Form SF12v2, Wexner Score (CCF-FIS) and the Sexual Function Questionnaire (SFQ). The patients' views on experience and treatment decision were obtained with a custom-designed questionnaire. Questionnaires were completed at a mean of 6.9 years following treatment.
RESULTS
The factors that influenced the patients' decisions were: experience satisfaction (p=0.003), postoperative bowel function (p<0.001), lower incontinence score (p=0.020) and agreement of TEMS experience with preoperative information (p=0.049). Treatment experience satisfaction was associated with family support (p=0.034) and agreement with preoperative information (p=0.047), better bowel function (p=0.026) and mental QoL (MCS) (p=0.003).
CONCLUSION
factors important to patients when reflecting on treatment experience are adequate and reliable information, a good QoL and the presence of family support. Clinicians should incorporate those parameters in their practice when assisting patients in making a surgical treatment choice and provide informed consent on TEMS for rectal cancer.
背景/目的：经肛门内镜微创手术（TEMS）是一种针对特定直肠癌的微创外科手术形式。本研究旨在探讨影响患者选择手术治疗决策的因素，并测量 TEMS 后的生活质量（QoL）。
患者和方法
研究了 34 名接受 TEMS 的 T1/T2-N0-M0 期直肠癌患者。使用的问卷包括简明健康状况调查问卷 12 项简表（SF12v2）、Wexner 评分（CCF-FIS）和性功能问卷（SFQ）。使用专门设计的问卷获得患者对治疗体验和治疗决策的看法。在治疗后平均 6.9 年完成问卷调查。
结果
影响患者决策的因素有：治疗体验满意度（p=0.003）、术后肠道功能（p<0.001）、较低的失禁评分（p=0.020）和 TEMS 治疗体验与术前信息的一致性（p=0.049）。治疗体验满意度与家庭支持（p=0.034）和与术前信息的一致性（p=0.047）、更好的肠道功能（p=0.026）和心理健康生活质量（MCS）（p=0.003）相关。
结论
患者在考虑治疗体验时重要的因素是充分和可靠的信息、良好的 QoL 和家庭支持。临床医生在协助患者选择手术治疗时应考虑这些参数，并在 TEMS 治疗直肠癌时提供知情同意。
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