摘要
目的探讨仅行新辅助化疗是否会影响直肠癌患者术后近期的肛门功能。方法从华西肠癌数据库(DACCA)2018年12月3日版本中提取行手术治疗的直肠癌患者的结构化数据,于2018年12月3日至2018年12月16日进行共14 d的电话随访调查,采用低位前切除综合征(LARS)评分量表评分来评价仅行新辅助化疗对直肠癌术后1年期肛门功能的影响。结果本研究提取了2016年10月至2017年10月期间符合纳入条件的209例就诊于四川大学华西医院胃肠外科的直肠癌且接受全直肠系膜切除术的患者,根据是否接受了新辅助化疗分为有新辅助化疗组(73例)和无新辅助化疗组(136例)。2组患者的基线资料除病理分期(P=0.022)和术后恢复时间(P<0.001)外,其他如年龄、体质量指数、性别、手术方式、肿瘤分化程度及吻合口位置比较差异均无统计学意义(P>0.050)。单因素分析结果显示,直肠癌患者的性别、年龄、体质量指数、病理分期、有无内科总体合并症、是否行新辅助化疗及术后恢复时间长短均与术后1年期LARS评分无关(P>0.050),但却与具体是否伴有心脏病(P=0.019)及吻合口位置距肛缘距离(P=0.005)有关。多因素分析结果显示,吻合口位置越高是患者术后1年期LARS发生的保护性因素(OR=0.706,P=0.003)。结论无论患者接受新辅助化疗与否,对患者术后肛门功能影响差异不大,提示增加单独的新辅助化疗未发现对直肠癌患者术后肛门功能的不良影响。
Objective To investigate whether neoadjuvant chemotherapy alone may affect recent anal function in patients with rectal cancer. Methods The structured data from the December 3, 2018 version of Database from Colorectal Cancer (DACCA) of West China Hospital were extracted . The follow-up investigation was performed within 2 weeks from December 3, 2018 to December 16, 2018 by the telephone. The postoperative anal function of patients with rectal cancer was evaluated by the lower anterior resection symptom (LARS) score questionnaire. Results A total of 209 patients with rectal cancer treated by the total mesolectal excision in the Department of Gastrointestinal Surgery of West China Hospital were included. One hundred and thirty-six patients of them were only treated with TME, while the other 73 patients were treated by the TME and neoadjuvant chemotherapy. As for the baseline data of the 2 groups, there was no difference in the age, body mass index, gender, surgical procedure, differentiation degree or anastomotic position (P>0.050), while the pathological staging (P=0.022) and postoperative recovery time (P<0.001) had the significant differences between these 2 groups. The postoperative 1-year LARS score was not associated with the gender, age, body mass index, pathological stage, physical comorbidity, neoadjuvant chemotherapy or time of postoperative recovery (P〉0.050), but which was associated with the heart disease (P=0.019) or position of anastomosis (P=0.005). Moreover, the multivariate analysis showed that the higher anastomosis position was a protective factor for the LARS after 1 year (OR=0.706, P=0.003). Conclusions There is no significant difference in postoperative anal function between patients with rectal cancer treated with neoadjuvant chemotherapy or not. It suggests that neoadjuvant chemotherapy has no more additional adverse effects on postoperative anal function in patients either.
作者
于瑞璇
何欣林
张秋露
安丽珉
黄明君
汪晓东
李立
YU Ruixuan;HE Xinlin;ZHANG Qiulu;AN Limin;HUANG Mingjun;WANG Xiaodong;LI Li(Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu 610041,P. R. China;West China School of Medicine,Sichuan University,Chengdu 610041,P. R. China;Department of Nursing,West China Hospital,Sichuan University,Chengdu 610041,P. R. China)
出处
《中国普外基础与临床杂志》
CAS
2019年第5期595-601,共7页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川省科技厅项目(项目编号:2019YFS0291)
四川大学大学生创新创业计划项目(项目编号:C2019105640)
关键词
新辅助化疗
直肠癌
低位前切除综合征
肛门功能
华西肠癌数据库
neoadjuvant chemotherapy
rectal cancer
lower anterior rectal resection syndrome
anal function
Database from Colorectal Cancer of West China Hospital