许多患者在接受结直肠癌和肛门癌治疗后会出现大便和排便相关症状--一项描述性研究

B. T. Oggesen
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摘要

目的:大便相关的晚期并发症对患者的生活质量有很大影响。本研究旨在调查大便和排便作为结直肠癌和肛门癌治疗晚期并发症的情况:我们在一个中心进行了一项前瞻性队列研究,采用了患者报告的结果测量方法。我们纳入了 2019 年 10 月至 2022 年 1 月期间接受结直肠癌和肛门癌手术的患者。此外,我们还纳入了肛门癌化疗和放疗后出现晚期并发症的亚组患者。研究对象包括 293 名患者。主要结果包括粪便和排便相关并发症的描述性数据。我们使用低位前切除症状评分(LARS)、圣马克失禁评分、布里斯托粪便形态量表、患者便秘症状评估评分(PAC-SYM)、结肠造口影响因子和视觉模拟量表的自我健康评价作为测量工具:直肠癌患者低位前切除症状评分的中位数为 36(24-41 分),肛门癌患者为 39(4-41 分),右侧或左侧半结肠切除患者分别为 26(4-41 分)和 25(0-41 分):结论:90%的直肠癌患者都有严重的低位前切除综合征(LARS)。接受结肠癌手术的患者中约有三分之一会出现大便或排便障碍。接受化疗和放疗的肛门癌患者的大便和排便障碍程度非常高。
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Many Patients Will Experience Stool and Bowel Movement-Related Symptoms After Treatment for Colorectal and Anal Cancer-A Descriptive Study
Purpose: Stool-related late complications have a major impact on patients’ quality of life. The objective of this study was to investigate stool and bowel movements as late complications to colorectal and anal cancer treatment. Methods: We performed a prospective cohort study from a single center using patient reported outcome measurements. We included patients who had surgery for colorectal and anal cancer from October 2019 to January 2022. This was supplemented by a subgroup of patients with late complications after chemo-radiation therapy for anal cancer. The study population comprised 293 patients. The main outcome included descriptive data on stool and bowel movement related complications. We used the Low Anterior Resection Symptom score (LARS), St Mark´s incontinence score, Bristol stool form scale, Patient Assessment of Constipation Symptoms Score (PAC-SYM), colostomy impact factor and self-rated health on a visual analog scale as measurement tools. Results: The low anterior resection symptom score was median 36 (range 24-41) in patients with rectum cancer, for patients with anal cancer it was 39 (4-41), for patients with a right or left sided hemicolectomy it was 26 (4-41) and 25 (0-41), respectively. Conclusion: Patients who had surgery for rectum cancer had in 90% of the cases major Low Anterior Resection Syndrome (LARS). Patients who underwent surgery for colon cancer would in about one third of the cases experience stool or bowel movement impairments. Patients with anal cancer who had chemo-radiation therapy experienced a very high degree of stool and bowel movement impairment.
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