Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia.
Colorectal Dis. 2021 Oct;23(10):2647-2658. doi: 10.1111/codi.15834. Epub 2021 Aug 4.
Postoperative functional outcomes following pelvic exenteration surgery for treatment of advanced or recurrent pelvic malignancies are poorly understood. The aim of this study was to determine the short-term functional outcomes following pelvic exenteration surgery using objective measures of physical function.
Patients undergoing pelvic exenteration surgery between January 2017 and May 2020 were recruited at a single quaternary referral hospital in Sydney, Australia. The primary measures were the 6-min walk test (6MWT) and the five times sit to stand (5STS) test. Data were collected at baseline (preoperatively), 10 days postoperatively and at discharge from hospital, and were analysed according to tumour type, extent of exenteration, sacrectomy, length of hospital stay, major nerve resection and postoperative complications.
The cohort of patients that participated in functional assessments consisted of 135 patients, with a median age of 61 years. Pelvic exenteration patients had a reduced 6MWT distance preoperatively compared to the general population (P < 0.001). Following surgery, we observed a further decrease in 6MWT distance (P < 0.001) and an increase in time to complete 5STS (P < 0.001) at postoperative day 10 compared to baseline, with a slight improvement at discharge. There were no differences in 6MWT and 5STS outcomes between patients based on comparisons of surgical and oncological factors.
Pelvic exenteration patients are functionally impaired in the preoperative period compared to the general population. Surgery causes a further reduction in physical function in the short term; however, functional outcomes are not impacted by tumour type, extent of exenteration, sacrectomy or nerve resection.
对于治疗晚期或复发性盆腔恶性肿瘤的盆腔廓清术，术后功能结局知之甚少。本研究旨在通过身体功能的客观测量来确定盆腔廓清术后的短期功能结局。
在澳大利亚悉尼的一家四级转诊医院招募了 2017 年 1 月至 2020 年 5 月期间接受盆腔廓清术的患者。主要测量指标是 6 分钟步行测试（6MWT）和 5 次坐立测试（5STS）。数据在基线（术前）、术后 10 天和出院时收集，并根据肿瘤类型、廓清范围、骶骨切除术、住院时间、主要神经切除和术后并发症进行分析。
参与功能评估的患者队列由 135 名患者组成，中位年龄为 61 岁。与一般人群相比，盆腔廓清患者术前的 6MWT 距离较短（P<0.001）。手术后，我们观察到 6MWT 距离在术后第 10 天进一步下降（P<0.001），完成 5STS 的时间增加（P<0.001），与基线相比，出院时略有改善。根据手术和肿瘤因素的比较，6MWT 和 5STS 结果在患者之间没有差异。
与一般人群相比，盆腔廓清术患者在术前就存在功能障碍。手术在短期内进一步降低了身体功能；然而，肿瘤类型、廓清范围、骶骨切除术或神经切除并不影响功能结局。
