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术后焦虑/抑郁是否会影响腹腔镜下腹膜直肠前突修补术治疗出口梗阻型便秘的长期功能结局?

Does Postoperative Anxiety/Depression Impair the Long-Term Functional Outcomes of Laparoscopic Ventral Rectopexy for Obstructed Defecation?

机构信息

Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

出版信息

J Laparoendosc Adv Surg Tech A. 2022 Sep;32(9):925-930. doi: 10.1089/lap.2021.0798. Epub 2022 Jan 20.

Abstract

This study aimed to investigate the relationship between postoperative anxiety/depression and functional outcomes of laparoscopic ventral rectopexy (LVR) for obstructed defecation (OD). Patients who received LVR for OD between March 2014 and July 2020 were enrolled. Patient demographics were recorded before surgery. The validated Cleveland Clinic Constipation Score (CCCS) and Patient Assessment of Constipation Quality of Life (PAC-QoL) were evaluated to assess functional outcomes and QoL, respectively. The self-rating anxiety scale and self-rating depression scale were used to measure anxiety and depression, respectively. Twenty-five patients were recruited. Significant improvement was found at last available follow-up (LAFU) in CCCS ( = .001), and three PAC-QoL subsets, physical discomfort ( = .003), satisfaction ( = .014), and worries/concerns ( = .033) during follow-up of 60 (11-84) months. In the patients with anxiety/depression ( = 11), significant improvement was found at LAFU in CCCS ( = .024) and the PAC-QoL subset, psychosocial discomfort ( = .038). In the patients without anxiety/depression ( = 14), improvement was found in CCCS ( = .009) and the PAC-QoL subset, physical discomfort ( = .018). The long-term functional outcomes of LVR for OD in patients with overt pelvic structural abnormalities are not undermined by postoperative anxiety/depression.

摘要

本研究旨在探讨腹腔镜下腹膜直肠前突修补术(LVR)治疗出口梗阻性便秘(OD)患者术后焦虑/抑郁与功能结局之间的关系。研究纳入了 2014 年 3 月至 2020 年 7 月期间接受 LVR 治疗 OD 的患者。记录患者术前的人口统计学数据。采用经过验证的克利夫兰便秘评分(CCCS)和患者便秘生活质量评分(PAC-QoL)评估功能性结局和生活质量,分别进行评估。采用焦虑自评量表和抑郁自评量表分别测量焦虑和抑郁。共纳入 25 例患者。在最后一次随访(LAFU)时,CCCS( = .001)显著改善,PAC-QoL 的三个子集,包括身体不适( = .003)、满意度( = .014)和担忧/顾虑( = .033),在 60(11-84)个月的随访中均得到改善。在有焦虑/抑郁的患者( = 11)中,CCCS( = .024)和 PAC-QoL 子集中的心理社会不适( = .038)在 LAFU 时显著改善。在无焦虑/抑郁的患者( = 14)中,CCCS( = .009)和 PAC-QoL 子集中的身体不适( = .018)得到改善。对于明显存在盆腔结构异常的 OD 患者,LVR 的长期功能结局不受术后焦虑/抑郁的影响。

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