腹腔镜直肠癌根治术对病人生活质量影响的分析

Quality-of-life analyses for patients with rectal cancer underwent radical laparoscopic surgery

目的:比较腹腔镜直肠癌根治术与传统开腹手术对病人术后生活质量(quality of life,QOL)的影响。方法:对照研究25例腹腔镜直肠癌根治术(腹腔镜组)和29例开腹直肠癌根治术(开腹组),采用欧洲癌症研究与治疗组织的癌症病人QOL评价量表QLQ-C30,评价和比较手术前后QOL的变化特征。结果:两组病人在年龄、性别、肿瘤与肛缘距离、TNM分期方面差异均无统计学意义。两组病人术后早期除情绪功能和认知功能以外的QOL总体评价较术前均明显下降,术后3～6个月,各项功能分值呈逐渐恢复趋势,腹腔镜组恢复显著早于开腹组(P<0.05)。总体健康状况量表的评价结果显示,腹腔镜组病人QOL恢复到中等以上水平的时间也显著早于开腹组。结论:腹腔镜直肠癌根治术不但创伤小、痛苦少、恢复快,且病人术后QOL恢复较开腹手术佳。

Objective To compare the impacts of radical laparoscopic surgery and conventional laparotomy on the quality of life （QOL） in patients with rectal cancer. Methods Quality of life questionnaire module, European Organisation for Research and Treatment of Cancer QLQ-C30, was used to evaluate the quality of life for all enrolled rectal cancer pa- tients peri-operatively. Results No significant difference was observed in terms of age, gender, tumor location, as well as TNM staging between the groups. Overall QOL early after operation decreased significantly in both groups of patients comparing with preoperative data, except for emotional function and cognitive function. The trend of QOL recovery was ob- served in both groups 3-6 months after operation. Furthermore, the QOL recovery was earlier in laparoseopie group than in open group （P〈0.05）. Overall rating scales of health condition showed that recovery was earlier for patients underwent laparoscopic surgery than for patients underwent conventional open laparotomy. Conclusions Laparoscopic rectal surgery is safe, effective and less traumatic. Patients might favor a better and earlier recovery of postoperative QOL undergoing laparoscopie surgery, as compared to conventional open surgery.