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低位前切除综合征对结直肠癌患者生活质量的影响:一项回顾性观察研究。

Effect of low anterior resection syndrome on quality of life in colorectal cancer patients: A retrospective observational study.

作者信息

Jin Dong-Ai, Gu Fang-Ping, Meng Tao-Li, Zhang Xuan-Xuan

机构信息

Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China.

Department of Ultrasound, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China.

出版信息

World J Gastrointest Surg. 2023 Oct 27;15(10):2123-2132. doi: 10.4240/wjgs.v15.i10.2123.

Abstract

BACKGROUND

Low anterior resection syndrome (LARS) is a common complication of anus-preserving surgery in patients with colorectal cancer, which significantly affects patients' quality of life.

AIM

To determine the relationship between the incidence of LARS and patient quality of life after colorectal cancer surgery and to establish a LARS prediction model to allow perioperative precision nursing.

METHODS

We reviewed the data from patients who underwent elective radical resection for colorectal cancer at our institution from April 2013 to June 2020 and completed the LARS score questionnaire and the European Organization for Research and Treatment of Cancer Core Quality of Life and Colorectal Cancer Module questionnaires. According to the LARS score results, the patients were divided into no LARS, mild LARS, and severe LARS groups. The incidence of LARS and the effects of this condition on patient quality of life were determined. Univariate and multivariate analyses were performed to identify independent risk factors for the occurrence of LARS. Based on these factors, we established a risk prediction model for LARS and evaluated its performance.

RESULTS

Among the 223 patients included, 51 did not develop LARS and 171 had mild or severe LARS. The following quality of life indicators showed significant differences between patients without LARS and those with mild or severe LARS: Physical, role, emotional, and cognitive function, total health status, fatigue, pain, shortness of breath, insomnia, constipation, and diarrhea. Tumor size, partial/total mesorectal excision, colostomy, preoperative radiotherapy, and neoadjuvant chemotherapy were identified to be independent risk factors for LARS. A LARS prediction model was successfully established, which demonstrated an accuracy of 0.808 for predicting the occurrence of LARS.

CONCLUSION

The quality of life of patients with LARS after colorectal cancer surgery is significantly reduced.

摘要

背景

低位前切除综合征(LARS)是结直肠癌患者保肛手术常见的并发症,严重影响患者生活质量。

目的

确定LARS发生率与结直肠癌手术后患者生活质量之间的关系,并建立LARS预测模型以实现围手术期精准护理。

方法

回顾2013年4月至2020年6月在我院接受择期结直肠癌根治性切除术患者的数据,完成LARS评分问卷以及欧洲癌症研究与治疗组织生活质量核心问卷和结直肠癌模块问卷。根据LARS评分结果,将患者分为无LARS组、轻度LARS组和重度LARS组。确定LARS的发生率及其对患者生活质量的影响。进行单因素和多因素分析以确定LARS发生的独立危险因素。基于这些因素,我们建立了LARS风险预测模型并评估其性能。

结果

纳入的223例患者中,51例未发生LARS,171例发生轻度或重度LARS。以下生活质量指标在无LARS患者与轻度或重度LARS患者之间存在显著差异:身体、角色、情感和认知功能、总体健康状况、疲劳、疼痛、气短、失眠、便秘和腹泻。肿瘤大小、直肠系膜部分/全切除、结肠造口术、术前放疗和新辅助化疗被确定为LARS的独立危险因素。成功建立了LARS预测模型,其预测LARS发生的准确率为0.808。

结论

结直肠癌手术后发生LARS的患者生活质量显著降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3d7/10642465/1a14c6933bb4/WJGS-15-2123-g001.jpg

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