腹腔镜直肠癌ISR和Miles术后患者生活质量对比研究

Clinical comparison of quality of life following laparoscopic ISR and Miles on rectal cancer

目的评价腹腔镜直肠癌经括约肌间切除技术(ISR)和腹会阴联合切除术(Miles)术后患者的生活质量。方法 2009年6月至2011年12月共有57例直肠癌患者进入本研究,其中ISR手术组21例,Miles手术组36例。以EORTC QLQ-C30、QLQ-CR38量表评估患者术前、术后9个月和术后18个月的生活质量。结果术前,ISR手术组患者排便问题少于Miles手术组患者,差异有统计学意义(P<0.05);两组患者其余各领域评分差异均无统计学意义(P>0.05)。术后两组患者各领域评分大致相当,仅在术后角色功能方面,ISR手术组患者优于Miles手术组(P<0.05);术后9个月,ISR手术组患者性功能优于Miles手术组(P<0.05);但Miles手术组患者术后未来期望优于ISR手术组(P<0.05)。结论与腹腔镜Miles手术比较,腹腔镜ISR手术对患者术后生活质量的影响仅显现有限优势,腹腔镜ISR手术对直肠癌患者生活质量的影响有待于进一步研究。

Objective To compare quality of life following laparoscopic intersphincteric resection (ISR)and Miles on rectal cancer. Methods From June 2009 to December 2011,57 patients with rectal cancer were recruited in this study.21 patients underwent laparoscopic ISR,36 patients had laparoscopic Miles. EORTC QLQ-C30 and QLQ- CR38 questionnaire were applied to evaluate quality of life baseline,9 months and 18 months after operation. Results Before operation,the median score of problems with defaecation in ISR group was lower.The median scores of other function domains and symptom domains were similar between two groups (P > 0.05).Postoperatively,the most median scores of function domains and symptom domains between two groups were similar (P > 0.05).The median postoperative score of role functioning in ISR group was higher than that in Miles group (P < 0.05).The postoperative score of sexual functioning in ISR group was higher than that in Miles group at 9 months after operation (P < 0.05). However,the postoperative score of future perspective was higher in Miles group (P < 0.05). Conclusion Only minimal benefits in postoperative quality of life are found with laparoscopic ISR in patients with rectal cancer compared with laparoscopic Miles,and further study is needed.