Quality of life after laparoscopic vs open sphincter-preserving resection for rectal cancer
| Autor: | Janet F. Y. Lee, Tony Wing-Chung Mak, Sophie S. F. Hon, Wing-Wa Leung, Simon S.M. Ng, Dennis Ngo, Cherry Yee-Ni Wong |
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| Rok vydání: | 2013 |
| Předmět: |
Laparoscopic surgery
Male medicine.medical_specialty China Time Factors Brief Article Colorectal cancer medicine.medical_treatment Anal Canal Postoperative Complications Quality of life Surveys and Questionnaires medicine Humans Longitudinal Studies Prospective Studies Laparoscopy Prospective cohort study Digestive System Surgical Procedures Aged Chi-Square Distribution medicine.diagnostic_test business.industry Rectal Neoplasms Gastroenterology General Medicine Anal canal Middle Aged medicine.disease humanities Surgery medicine.anatomical_structure Treatment Outcome Quality of Life Sphincter Female business Chi-squared distribution Organ Sparing Treatments |
| Zdroj: | World journal of gastroenterology. 19(29) |
| ISSN: | 2219-2840 |
| Popis: | AIM: To compare quality of life (QoL) outcomes in Chinese patients after curative laparoscopic vs open surgery for rectal cancer. METHODS: Eligible Chinese patients with rectal cancer undergoing curative laparoscopic or open sphincter-preserving resection between July 2006 and July 2008 were enrolled in this prospective study. The QoL outcomes were assessed longitudinally using the validated Chinese versions of the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR38 questionnaires before surgery and at 4, 8, and 12 mo after surgery. The QoL scores at the different time points were compared between the laparoscopic and open groups. A higher score on a functional scale indicated better functioning, whereas a higher score on a symptom scale indicated a higher degree of symptoms. RESULTS: Seventy-four patients (49 laparoscopic and 25 open) were enrolled. The two groups of patients were comparable in terms of sociodemographic data, types of surgery, tumor staging, and baseline mean QoL scores. There was no significant decrease from baseline in global QoL for the laparoscopic group at different time points, whereas the global QoL was worse compared to baseline beginning at 4 mo but returned to baseline by 12 mo for the open group (P = 0.019, Friedman test). Compared to the open group, the laparoscopic group had significantly better physical (89.9 ± 1.4 vs 79.2 ± 3.7, P = 0.016), role (85.0 ± 3.4 vs 63.3 ± 6.9, P = 0.005), and cognitive (73.5 ± 3.4 vs 50.7 ± 6.2, P = 0.002) functioning at 8 mo, fewer micturition problems at 4-8 mo (4 mo: 32.3 ± 4.7 vs 54.7 ± 7.1, P = 0.011; 8 mo: 22.8 ± 4.0 vs 40.7 ± 6.9, P = 0.020), and fewer male sexual problems from 8 mo onward (20.0 ± 8.5 vs 76.7 ± 14.5, P = 0.013). At 12 mo after surgery, no significant differences were observed in any functional or symptom scale between the two groups, with the exception of male sexual problems, which remained worse in the open group (29.2 ± 11.3 vs 80.0 ± 9.7, P = 0.026). CONCLUSION: Laparoscopic sphincter-preserving resection for rectal cancer is associated with better preservation of QoL and fewer male sexual problems when compared with open surgery in Chinese patients. These findings, however, should be interpreted with caution because of the small sample size of the study. |
| Databáze: | OpenAIRE |
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