直肠癌经腹会阴联合切除术与低位前切除术患者长期生活质量的比较

Comparison of quality of life between the patients following abdominoperineal resection and low anterior resection for rectal cancer

目的比较经腹会阴联合切除术(abdominoperineal resection,APR)与低位前切除术(low anterior resection,LAR)两种术式对直肠癌患者长期生活质量的影响。方法回顾性分析2007年1月至2013年10月间接受APR和LAR术式的低位直肠癌患者的临床资料。采用结直肠癌生活质量测量量表29(Quality of life questionnaire-Colorectal Cancer29,QLQ-CR29)对APR组和LAR组患者的生活质量进行比较。结果最终有完整问卷的患者164例(APR组50例,LAR组114例)。APR组患者的平均年龄(57.4±10.3)岁,显著高于LAR组(50.8±6.9)岁(P<0.001)。两组患者在性别、体重指数、术前ASA评分、术前临床分期方面无统计学差异。接受APR手术的患者在排尿和排便方面QLQ-CR29评分优于LAR组,LAR组患者在术后1个月和6个月的主观感受方面以及术后12个月大便情况方面明显优于APR组。结论接受APR手术的患者术后长期生活质量并不逊于接受LAR术式的患者。

Objective To compare the long-term quality of life between the patients following abdominoperineal resection(APR)and that after low anterior resection(LAR)in patients with rectal cancer.Methods Clinical and follow-up data of the patients following LAR and APR for rectal cancer from January2007 to October 2013 were retrospectively analyzed.Quality of life questionnaire-Colorectal Cancer29(QLQCR29)was used to evaluate the quality of life.The clinicopathological parameters and long-term quality of life were compared between the two groups.Results The follow-up of long-term quality of life was successfully finished in 164 cases including 50 cases in the APR group and 114 in the LAR group.The mean age of the APR group was(57.4±10.3)years,significantly higher than(50.8±6.9)years of the LAR group(P<0.001).There were no significant differences in sex,body mass index,preoperative ASA scores,clinical tumor stages between the two groups.The patients undergoing APR had lower scores in the items of urination and defecation than those following LAR,while better scores were found in patients’subjective feelings on the postoperative first and sixth month,and stool status on the postoperative 12 th month in the LAR group.Conclusion The patients following APR for low rectal cancer have a similar long-term quality of life as those undergoing LAR.