Gielen Anke H C, Heuvelings Danique J I, Sylla Patricia, van Loon Yu-Ting, Melenhorst Jarno, Bouvy Nicole D, Kimman Merel L, Breukink Stephanie O
Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.
Dis Colon Rectum. 2025 Feb 1;68(2):154-170. doi: 10.1097/DCR.0000000000003478. Epub 2024 Oct 23.
Colorectal anastomotic leakage remains one of the most frequent and dreaded postoperative complications after colorectal resection. However, limited research has been conducted on the impact of this complication on the quality of life of patients who have undergone colorectal cancer surgery.
The aim of this systematic review was to identify, appraise, and synthesize the available evidence regarding the quality of life in patients with anastomotic leakage after oncological colorectal resections to inform clinical decision-making.
PubMed, Embase, and the Cochrane Library were searched for studies reporting quality of life using validated questionnaires in patients with anastomotic leakage after oncological colorectal resections. The literature search was performed systematically and according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Outcomes from quality-of-life questionnaires of patients with and without anastomotic leakage were analyzed.
Thirteen articles reporting on 4618 individual patients were included, among which 527 patients developed anastomotic leakage. Quality of life was evaluated using 10 distinct questionnaires administered at various postoperative time points, ranging from 1 month to 14 years. Quality-of-life outcomes differed across studies and time points, but overall scores were most negatively affected by anastomotic leakage up to 12 months postoperatively.
There was a high heterogeneity between the included studies based on the questionnaires used and the time of assessment.
The published evidence suggests that anastomotic leakage after oncologic colorectal resection is associated with impaired quality of life, especially within the first postoperative year. The impact of anastomotic leakage on quality of life warrants further evaluation and discussion with patients.
结直肠吻合口漏仍然是结直肠切除术后最常见且令人担忧的术后并发症之一。然而，关于这一并发症对接受结直肠癌手术患者生活质量影响的研究有限。
本系统评价的目的是识别、评估和综合有关肿瘤性结直肠切除术后吻合口漏患者生活质量的现有证据，为临床决策提供依据。
检索了PubMed、Embase和Cochrane图书馆，以查找使用经过验证的问卷报告肿瘤性结直肠切除术后吻合口漏患者生活质量的研究。文献检索按照系统评价和Meta分析的首选报告项目指南进行系统开展。
纳入了13篇报告4618例个体患者的文章，其中527例患者发生了吻合口漏。使用10种不同的问卷在术后1个月至14年的不同时间点对生活质量进行了评估。不同研究和时间点的生活质量结果有所不同，但总体评分在术后12个月内受吻合口漏的负面影响最大。
基于所使用的问卷和评估时间，纳入的研究之间存在高度异质性。
已发表的证据表明，肿瘤性结直肠切除术后的吻合口漏与生活质量受损有关，尤其是在术后第一年。吻合口漏对生活质量的影响值得进一步评估并与患者进行讨论。
