Yuanyuan Wu, Shiyin He, Lei He, Ding Ding
Department of General Surgery, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, Anhui, China.
Front Oncol. 2023 Apr 20;13:1168807. doi: 10.3389/fonc.2023.1168807. eCollection 2023.
Pelvic floor rehabilitation has been reported to be effective in improving fecal incontinence. The aim of this study was to prospectively evaluate the effectiveness of combined pelvic floor muscle exercises (PFMEs) and loperamide treatment on rectal function and mental health for low anterior resection syndrome (LARS) patients after sphincter-saving operation (SSO) for rectal cancer.
A total of 60 inpatients diagnosed with LARS were enrolled and randomly assigned to one of two groups: patients in Group A (n = 30) were treated with a PFME intervention and those in Group B (n = 30) with a control intervention for 4 weeks. High-resolution anorectal manometry (HRAM) was performed for all LARS patients. Demographic information was collected for all patients, and they subsequently also completed several questionnaires, including the Hospital Anxiety and Depression Scale (HADS), a measure of Wexner score, a measure of stool frequency per day, and the Bristol Stool Form Scale (BSFS).
No significant differences between the groups were observed in baseline data. With regard to rectal function, we found significant improvements at week 4 in maximal resting pressure (MRP) (39.93 ± 5.02 28.70 ± 5.40 mmHO, p < 0.001) and maximal squeeze pressure (MSP) (132.43 ± 8.16 mmHO 113.33 ± 9.87 mmHO, p < 0.001) among Group A patients compared to Group B patients. Additionally, Wexner scores were significantly lower in Group A than in Group B at week 4 (8.10 ± 1.24 9.87 ± 1.29 ml, p = 0.018), as were stool frequency (6.47 ± 0.90 7.83 ± 0.93, p < 0.001) and BSFS scores (5.17 ± 0.65 6.10 ± 0.80, p = 0.020). Notably, HADS scores were also significantly lower in Group A than in Group B at week 4 (8.25 ± 2.36 10.48 ± 3.01, p < 0.001). Additionally, both anxiety scores (4.16 ± 1.38 5.33 ± 1.69, p < 0.001) and depression scores (4.09 ± 1.56 5.15 ± 1.89, p < 0.001) were significantly lower in Group A than in Group B at week 4.
Pelvic floor muscle exercises are an effective treatment that can alleviate symptoms and improve rectal function and mental health in patients with low anterior resection syndrome.
据报道，盆底康复对改善大便失禁有效。本研究的目的是前瞻性评估盆底肌肉锻炼（PFMEs）与洛哌丁胺联合治疗对直肠癌保肛手术（SSO）后低位前切除综合征（LARS）患者直肠功能和心理健康的有效性。
共纳入60例诊断为LARS的住院患者，并随机分为两组：A组（n = 30）患者接受PFME干预，B组（n = 30）患者接受对照干预，为期4周。对所有LARS患者进行高分辨率肛门直肠测压（HRAM）。收集所有患者的人口统计学信息，随后他们还完成了几份问卷，包括医院焦虑抑郁量表（HADS）、韦克斯纳评分量表、每日大便频率量表和布里斯托大便分类量表（BSFS）。
两组患者的基线数据无显著差异。在直肠功能方面，我们发现，与B组患者相比，A组患者在第4周时最大静息压（MRP）（39.93±5.02 mmHg对28.70±5.40 mmHg，p<0.001）和最大收缩压（MSP）（132.43±8.16 mmHg对113.33±9.87 mmHg，p<0.001）有显著改善。此外，A组在第4周时的韦克斯纳评分显著低于B组（8.10±1.24对9.87±1.29，p = 0.018），大便频率（6.47±0.90对7.83±0.93，p<0.001）和BSFS评分（5.17±0.65对6.10±0.80，p = 0.020）也是如此。值得注意的是，A组在第4周时的HADS评分也显著低于B组（8.25±2.36对10.48±3.01，p<0.001）。此外，A组在第4周时的焦虑评分（4.16±1.38对5.33±1.69，p<0.001）和抑郁评分（4.
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