Dulskas Audrius, Petrauskas Vidas, Kuliavas Justas, Bickaite Klaudija, Kairys Mikalojus, Pauza Kastytis, Kilius Alfredas, Sangaila Egidijus, Bausys Rimantas, Stratilatovas Eugenijus
Departament of General and Abdominal Surgery and Oncology, National Cancer Institute, LT-08406 Vilnius, Lithuania.
Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.
J Clin Med. 2021 Feb 15;10(4):768. doi: 10.3390/jcm10040768.
The aim of this study was to assess quality of life and bowel function in patients undergoing early vs. standard ileostomy closure. We retrospectively assessed patients from our previous randomized controlled trial. Patients with a temporary ileostomy who underwent rectal cancer surgery and did not have anastomotic leakage or other. Early closure (EC; 30 days after creation) and standard closure (SC; 90 days after creation) of ileostomy were compared. Thirty-six months (17-97) after stoma closure, we contacted patients by phone and filled in two questionnaires-The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and low anterior resection syndrome (LARS) score. This index trial was not powered to assess the difference in bowel function between the two groups. All the patients in the SC group had anastomosis <6 cm from the anal verge compared to 42 of 43 (97.7%) in the EC group. There were no statistically significant differences between EC (26 patients) and SC (25 patients) groups in the EORTC QLQ-C30 and LARS questionnaires. Global quality of life was 37.2 (0-91.7; ±24.9) in the EC group vs. 34.3 (0-100; ±16.2) in the SC ( = 0.630). Low anterior resection syndrome was present in 46% of patients in the EC and 56% in the SC group ( = 0.858). Major LARS was found more often in younger patients. However, no statistical significance was found ( = 0.364). The same was found with quality of life ( = 0.219). Age, gender, ileostomy closure timing, neoadjuvant treatment, complications had no effect of worse bowel function or quality of life. There was no difference in quality of life or bowel function in the late postoperative period after the early vs. late closure of ileostomy based on two questionnaires and small sample size. None of our assessed risk factors had a negative effect on bowel function o quality of life.
本研究的目的是评估早期与标准回肠造口关闭术患者的生活质量和肠道功能。我们回顾性评估了来自之前随机对照试验的患者。接受直肠癌手术且无吻合口漏或其他情况的临时回肠造口患者。比较了回肠造口的早期关闭(EC;造口形成后30天)和标准关闭(SC;造口形成后90天)。造口关闭36个月(17 - 97个月)后,我们通过电话联系患者并填写两份问卷——欧洲癌症研究与治疗组织生活质量问卷核心30(EORTC QLQ - C30)和低位前切除综合征(LARS)评分。该指标试验无能力评估两组之间肠道功能的差异。SC组所有患者的吻合口距肛缘<6 cm,而EC组43例中有42例(97.7%)如此。在EORTC QLQ - C30和LARS问卷中,EC组(26例患者)和SC组(25例患者)之间无统计学显著差异。EC组的总体生活质量为37.2(0 - 91.7;±24.9),而SC组为34.3(0 - 100;±16.2)(P = 0.630)。EC组46%的患者和SC组56%的患者存在低位前切除综合征(P = 0.858)。主要的LARS在年轻患者中更常见。然而,未发现统计学显著差异(P = 0.364)。生活质量方面也是如此(P = 0.219)。年龄、性别、回肠造口关闭时间、新辅助治疗、并发症对肠道功能恶化或生活质量无影响。基于两份问卷和小样本量,回肠造口早期与晚期关闭术后晚期的生活质量或肠道功能无差异。我们评估的风险因素均未对肠道功能或生活质量产生负面影响。