Đánh giá chất lượng cuộc sống của bệnh nhân ung thư trực tràng trên và giữa được điều trị phẫu thuật nội soi cắt trực tràng trước thấp

Author(s):  
Thong Tran Ngoc

Introduction: Evaluation of the quality of life of patients with upper and middle rectal cancer treated with laparoscopic low anterior resection. Material and method: Prospective and previous research from 1/2013 to 9/2019 at Hue central hospital, a laparoscopic low anterior resection was performed in 86 patients with upper and mid rectal cancer. Result: There were 40 males and 45 females with the mean age of 62,95 ± 13,13; no conversion, have seven cases anastomotic leakage. Mean follow-up duration 60 months: have five cases local recurrence (5,9%), the overall survival rate after 5 years was 45%. Quality of Life of Patients is quiet good. Conclusion: Laparoscopic low anterior resection for treatment upper and mid rectal cancer is safe and effective, quality of life of patient is quite good.

2017 ◽  
pp. 182-189
Author(s):  
Ngoc Thang Tran ◽  
Ngoc Hung Dang ◽  
Manh Ha Le ◽  
Anh Vu Pham ◽  
Nhu Hiep Pham ◽  
...  

Introduction: To evaluate the feasibility and benefits of laparoscopic low anterior resection for upper and middle rectal cancer treatment. Material and method: Prospective study from 8/2013 to 8/2017 at Hue Central Hospital, a laparoscopic low anterior resection was performed in 45 patients with upper and mid rectal cancer. Result: There were 29 males and 16 females with the mean age of 60.3 ± 11.5 (range 38 – 75), no conversion, have three cases anastomotic leakage, the mortaliy rate was 0%. Mean follow-up duration 36 months: have tow cases local recurrence (4.4%), the overall survival rate was 100%. Conclusion: Laparoscopic low anterior resection for treatment upper and mid rectal cancer is safe and effective, initial results is good. Key words: upper and middle rectal cancer, Laparoscopic low anterior resection


2021 ◽  
Vol 20 (1) ◽  
pp. 59-67
Author(s):  
A. B. Serebriy ◽  
E. A. Khomyakov ◽  
I. O. Nafedzov ◽  
O. Yu. Fomenko ◽  
E. G. Rybakov

Aim: search for modifiable and unmodifiable risk factors affecting the quality of life of patients after rectal cancer surgery.Materials and methods: the literature search was done according to the keywords: quality of life, rectal cancer, low anterior resection syndrome. Twelve prospective randomized studies, 2 cohort studies, and 2 meta-analyses are included in the study. The quality of life was assessed in the analyzed studies by using questionnaires for cancer patients and updated questionnaires for colorectal cancer: EORTC QLQ-CR29, QLQ-C30, QLQ-CR38, BIQ.Results: the literary data on influence of gender, age, surgery, stoma, and chemoradiotherapy on life quality of patients after rectal cancer surgery was analyzed.Conclusion: the most significant factor affecting the life quality of patients with rectal cancer is a violation of the body image if it is necessary to form the stoma on the anterior abdominal wall. The manifestations of the low anterior resection syndrome and the urination problems are significant risk factors in the case of restoration of bowel continuity.


2017 ◽  
Vol 25 (4) ◽  
pp. 642-654
Author(s):  
E. P. Kulikov ◽  
Yu. D. Kaminsky ◽  
S. V. Klevcova

For many decades the main goal of oncologists was to increase life expectancy of patients with malignant tumors, without paying due attention to quality of life. Currently, the goals of patients’ treatment with rectal cancer are to cure, to minimize the risk of local recurrence, preserve the normal course of intestine, to optimize it's function and to ensure quality of life. For a long time, the standard surgical treatment of patients with low rectal cancer was abdominoperineal extirpation, but recently sphincterosafing operations have seen a widespread introduction in surgical practice. However, functional results after these types of operations don't always meet the expectations of surgeons and patients. In the postoperative period, patients often develop a syndrome of low anterior resection, characterized by frequent bowel movements, repeated, prolonged and incomplete evacuation of bowel and the imperative urge to defecate. The manifestation of this syndrome can significantly impair the quality of patient's life and reduce to nothing the efforts of the surgeon to preserve the sphincter of the rectum. For surgical correction of low anterior resection syndrome, various types of colonic reservoir anastomoses have been proposed. The purpose of formation of colonic reservoirs is to increase the cumulative function of intestine. However, the existing methods have several disadvantages related to technical complications and the risk of developing evacuation dysfunction, which is the reason for search the new ways of optimization of anastomoses when performing sphincterotomy operations for cancer of the rectum.


2019 ◽  
Vol 28 (3) ◽  
pp. 1199-1206 ◽  
Author(s):  
Ali Bohlok ◽  
Camille Mercier ◽  
Fikri Bouazza ◽  
Maria Gomez Galdon ◽  
Luigi Moretti ◽  
...  

2019 ◽  
Vol 37 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Maarten van Heinsbergen ◽  
Jeroen W. Leijtens ◽  
Gerrit D. Slooter ◽  
Maryska L. Janssen-Heijnen ◽  
Joop L. Konsten

Background/Aims: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. Studies investigating LARS and the effect on QoL after transanal endoscopic microsurgery (TEM) for rectal cancer are scarce. The aim of our study was to assess bowel dysfunction and QoL after TEM. Methods: Seventy-three ­patients who underwent TEM for stage I rectal cancer were included in this single-centre, cross-sectional study Bowel dysfunction was assessed by the LARS-Score, QoL by the ­European Organization for the Research and Treatment of Cancer QLQ-C30 and -CR29 questionnaires. Results: Fifty-five respondents (75.3%) could be included for the analyses. The median interval since treatment was 4.3 years, and the median age at the follow-up point was 72 years. “Major LARS” was observed in 29% of patients and “minor LARS” in 26%. Female gender (OR 4.00; 95% CI 1.20–13.36), neo-adjuvant chemoradiotherapy (OR 3.63; 95% CI 1.08–12.17) and specimen thickness in millimetres (OR 1.10 for each mm increase in thickness; 95% CI 1.01–1.20) were associated with the development of major LARS. Patients with major LARS fared worse in most QoL domains. Conclusion: This is the first study demonstrating major LARS after TEM treatment for rectal cancer, with a negative effect on QoL, even years after treatment. Our data provides an adequate counselling before TEM in terms of postoperative bowel dysfunction and its effect on QoL.


2020 ◽  
Author(s):  
Yuwen Luo ◽  
Rongjiang Li ◽  
Deqing Wu ◽  
Jun Zeng ◽  
Junjiang Wang ◽  
...  

Abstract Aim To analyze the effect of preserving the left colic artery (LCA) on long-term oncologic outcomes during laparoscopic low anterior resection of rectal cancer. Methods Clinicopathological and follow-up patients undergoing laparoscopic low anterior resection of rectal cancer in general surgery department of Guangdong Provincial People's Hospital from January 2014 to December 2015 were retrospectively collected. According to the difference surgical methods of inferior mesenteric artery (IMA), 159 cases were divided into the LCA preservation group and 225 cases in the LCA non-preservation group. The 5-year rates of overall survival (OS) and disease-free survival (DFS) were compared between two group. Results 384 patients were included in final analysis. Anastomotic leakage occurred in 7 patients (4.4%) in the LCA preservation group and in 16 patients (7.1%) in the LCA non-preservation group. The follow-up rate was 91.2% (145/159) during 5–60 months in LCA preservation group, and 89.8% (202/225) during 5–60 months in the LCA non-preservation group. The number of patients who developed death, local recurrence and metastasis were 59 (37.1%), 13 (8.2%) and 60 (37.7%) in the LCA preservation group, and 86 (38.2%), 20 (8.9%) and 92 (40.9%) in the LCA non-preservation group, without significant differences (all P ༞ 0.05). The 5-year OS and DFS rates were 69.0% and 59.3% in the LCA preservation group, and 68.8% and 55.9% in the LCA non-preservation group, without significant differences (all P ༞ 0.05). After stratification by TNM Stage, the difference on 5-year OS rates and DFS rates of I stage, II stage and III stage in two groups were no significant as well (all P ༞ 0.05). Conclusions The long-term oncologic outcomes of laparoscopic low anterior resection of rectal cancer with preservation of the LCA are comparable with ligation at origin of IMA.


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