Planellas P, Fernandes-Montes N, Golda T, Alonso-Gonçalves S, Elorza G, Gil J, Kreisler E, Abad-Camacho M R, Cornejo L, Marinello F
Colorectal Surgery Unit, University Hospital of Girona, Department of Medical Sciences, Faculty of Medicine University Hospital of Girona, University of Girona, Girona Biomedical Research Institute (IDIBGI), Avinguda de França S/N, 17007, Girona, Spain.
Colorectal Surgery Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona UAB, Barcelona, Spain.
Tech Coloproctol. 2025 Jan 4;29(1):42. doi: 10.1007/s10151-024-03089-w.
Patients with rectal cancer often experience adverse effects on urinary, sexual, and digestive functions. Despite recognised impacts and available treatments, they are not fully integrated into follow-up protocols, thereby hindering appropriate interventions. The aim of the study was to discern the activities conducted in our routine clinical practice outside of clinical trials.
This multicentre, retrospective cohort study included consecutive patients undergoing rectal cancer surgery between January 2016 and January 2020 at six tertiary Spanish hospitals.
A total of 787 patients were included. Two years post surgery, gastrointestinal evaluation was performed in 86% of patients. However, bowel movements per day were only recorded in 242 patients (46.4%), and the values of the Low Anterior Resection Syndrome (LARS) questionnaire were recorded in 106 patients (20.3%); 146 patients received a diagnosis of fecal incontinence (28.2%), while 124 patients were diagnosed with low anterior resection syndrome (23.8%). Urogenital evaluation was recorded in 21.1% of patients. Thirty-seven patients (5.1%) were detected to have urinary dysfunction, while 40 patients (5.5%) were detected to have sexual dysfunction. A total of 320 patients (43.9%) had their quality of life evaluated 2 years after surgery, and only 0.8% completed the Quality of Life questionnaire. Medication was the most used treatment for sequelae (26.9%) followed by referral to other specialists (15.1%).
There is a significant deficit in clinical follow-ups regarding the functional assessment of patients undergoing rectal cancer surgery. It is crucial to implement a postoperative functional follow-up protocol and to utilize technologies such as Patient-Reported Outcome Measures (PROMs) to enhance the evaluation and treatment of these sequelae, thereby ensuring an improved quality of life for patients.
直肠癌患者常出现泌尿、性功能及消化功能方面的不良反应。尽管这些影响已得到认识且有相应治疗方法，但它们并未完全纳入随访方案，从而阻碍了适当的干预措施。本研究的目的是了解我们在常规临床实践（非临床试验）中开展的活动。
这项多中心回顾性队列研究纳入了2016年1月至2020年1月期间在西班牙六家三级医院接受直肠癌手术的连续患者。
共纳入787例患者。术后两年，86%的患者接受了胃肠道评估。然而，仅242例患者（46.4%）记录了每日排便情况，106例患者（20.3%）记录了低位前切除综合征（LARS）问卷的值；146例患者被诊断为大便失禁（28.2%），124例患者被诊断为低位前切除综合征（23.8%）。21.1%的患者进行了泌尿生殖系统评估。37例患者（5.1%）被检测出存在排尿功能障碍，40例患者（5.5%）被检测出存在性功能障碍。共有320例患者（43.9%）在术后两年进行了生活质量评估，仅0.8%的患者完成了生活质量问卷。药物是最常用的后遗症治疗方法（26.9%），其次是转诊至其他专科医生（15.1%）。
在直肠癌手术患者的功能评估方面，临床随访存在显著不足。实施术后功能随访方案并利用患者报告结局测量（PROMs）等技术来加强对这些后遗症的评估和治疗至关重要，从而确保患者生活质量得到改善。
