Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada.
Colorectal Dis. 2021 Jul;23(7):1777-1784. doi: 10.1111/codi.15633. Epub 2021 Apr 14.
The aim of this study was to assess bowel-related financial stress and strain and to evaluate its association with global quality of life.
This was a retrospective cohort study with cross-sectional follow-up including consecutive patients who underwent restorative proctectomy for neoplastic disease of the rectum at a single university-affiliated hospital in Montreal, Quebec, Canada. Bowel-related financial impact and occupational impact were compared between patients with major low anterior resection syndrome (LARS) and those with minor/no LARS. The association between LARS, bowel-related financial impact and global quality of life (QoL) was then assessed in a multiple logistic regression model.
Of 180 eligible rectal cancer survivors who were contacted, 154 completed the questionnaires (response rate 47.1%) at a median follow-up of 57.5 months (interquartile range 34.1-98.1) after proctectomy. Individuals with major LARS reported a higher prevalence of bowel-related financial stress (53.2% vs 5.6%, p < 0.001) and strain (42.2% vs 5.6%, p < 0.001) compared with those with minor/no LARS. Among those who were working preoperatively (n = 100), the majority of participants with major LARS reported an impact of their new bowel function on their ability to work (70.6%), including delayed return to work (44.1%), the need to change schedules (35.3%) or roles (20.6%), and complete long-term medical absence from work (14.7%). On multiple logistic regression, major LARS with financial impact (OR 4.50, 95% CI 1.57-13.77) was associated with low global QoL compared with minor/no LARS.
Major LARS was associated with considerable financial stress and strain and difficulties in returning to work.
本研究旨在评估与肠道相关的经济压力和负担，并评估其与整体生活质量的关系。
这是一项回顾性队列研究，采用横断面随访，纳入了在加拿大魁北克省蒙特利尔市的一家大学附属医院接受直肠肿瘤保肛切除术的连续患者。比较了主要低位前切除综合征（LARS）患者和非主要/无 LARS 患者的肠道相关经济影响和职业影响。然后，在多因素逻辑回归模型中评估 LARS、与肠道相关的经济影响和整体生活质量（QoL）之间的关联。
在联系的 180 名符合条件的直肠癌幸存者中，154 名在直肠切除术后中位数随访 57.5 个月（四分位间距 34.1-98.1）时完成了问卷（应答率 47.1%）。与非主要/无 LARS 患者相比，主要 LARS 患者报告肠道相关经济压力（53.2% vs 5.6%，p<0.001）和负担（42.2% vs 5.6%，p<0.001）的发生率更高。在术前工作的 100 名患者中，大多数主要 LARS 患者报告他们新的肠道功能对其工作能力有影响（70.6%），包括延迟返工（44.1%）、需要改变工作时间（35.3%）或角色（20.6%）以及长期完全因病缺勤（14.7%）。在多因素逻辑回归中，与非主要/无 LARS 相比，主要 LARS 伴经济影响（OR 4.50，95%CI 1.57-13.77）与整体 QoL 较低相关。
主要 LARS 与相当大的经济压力和负担以及重返工作岗位的困难有关。
