Quality of Life in Patients with Low Anterior Resection

Year 2022, Volume: 48 Issue: 1, 31 - 36, 01.04.2022

Ercüment Gürlüler , Murat Şen , İlker Yalçın , Oğuz Kızılaslan , Özgen Işık , Tuncay Yılmazlar

https://doi.org/10.32708/uutfd.1081127

Abstract

The aim of this study is to evaluate the relationship between Low Anterior Resection Syndrome (LARS) and quality of life (QOL). Patients who had operated on in our clinic due to rectal cancer were included in the study. In total 52 patients underwent rectal resection between the study period, 24 patients were excluded from the study, 28 patients included in the study. Quality of life (QOL), European cancer quality of life research and treatment survey-C30 (EORTC QLQ C-30), and bowel functions were evaluated using LARS score. In our clinic, between 19th January 2017 and 31th March 2019, all patients who were operated on due to rectum cancer and who underwent sphincter sparing procedures were taken from the prospective database. Patients who continued their follow-up in our outpatient clinic and wanted to participate in the survey were included in the study, and face-to-face surveys were carried out with them. The relationship between LARS and QOL was analyzed. The percentage of the patients who had major LARS is %53.7. QOL was closely related to LARS. There was a significant difference between patients with Major LARS and patients without major LARS in their global health status and functional scale (physical, role, emotional, cognitive, social) Patients with Major LARS had more diarrhea, fatigue, insomnia, and pain. Anastomosis level (low) was an important risk factor for major LARS (p<0.001). More than half of the patients had major LARS. Patients with Major LARS had lower QOL than patients with no/minor LARS. The presence of major LARS after rectal resection for cancer is negatively related to global health as well as many other aspects of QOL (p<0.001). Maintaining anorectal function and treating LARS are potential measures to improve QOL in this patient group.

Keywords

Rectum, cancer, oncology, surgery, low anterior resection

Low Anterior Rezeksiyon Yapılan Hastalarda Hayat Kalitesi

Abstract

Bu çalışmanın amacı Low Anterior Rezeksiyon Sendromu (LARS) ile yaşam kalitesi (QOL) arasındaki ilişkiyi değerlendirmektir. Kliniğimizde rektum kanseri nedeniyle ameliyat olan hastalar çalışmaya dahil edildi. Çalışma periyodu arasında toplam 52 hastaya rektal rezeksiyon uygulandı, 24 hasta çalışma dışı bırakıldı, 28 hasta çalışmaya dahil edildi. Yaşam kalitesi (QOL), Avrupa kanser yaşam kalitesi araştırma ve tedavi anketi-C30 (EORTC QLQ C-30) ve bağırsak fonksiyonları LARS skoru kullanılarak değerlendirildi. Kliniğimizde 19 Ocak 2017-31 Mart 2019 tarihleri arasında rektum kanseri nedeniyle ameliyat edilen ve sfinkter koruyucu cerrahi uygulanan tüm hastalar retrospektif veri tabanından alınmıştır. Polikliniğimizde takiplerine devam eden ve ankete katılmak isteyen hastalar çalışmaya dahil edilmiş ve hastalarla yüz yüze anket yapılmıştır. LARS ve QOL arasındaki ilişki analiz edilmiştir. Majör LARS olan hastaların oranı %53,7'dir. QOL, LARS ile yakından ilişkiliydi. Majör LARS hastaları ile majör LARS olmayan hastalar arasında global sağlık durumları ve fonksiyonel ölçekleri (fiziksel, rol, duygusal, bilişsel, sosyal) açısından anlamlı bir fark vardı. Anastomoz seviyesi (alçak anastomoz) majör LARS için önemli bir risk faktörüydü (p<0,001). Hastaların yarısından fazlasında majör LARS vardı. Majör LARS hastalarının yaşam kalitesi, LARS olmayan/minör hastalara göre daha düşüktü. Kanser için rektal rezeksiyondan sonra majör LARS varlığı, QOL ölçeğinin diğer birçok parametresi gibi genel sağlık durumuyla da negatif ilişkilidir (p<0,001). LARS yaşam kalitesini etkileyebilir. Bu nedenle rektum kanserinden tedavi olan hastalarda fonksiyonel problemlere odaklanmak gerekir. Anorektal fonksiyonun sürdürülmesi ve LARS tedavisi bu hasta grubunda yaşam kalitesini iyileştirmeye yönelik potansiyel önlemlerdir.

Keywords

Rektum, kanser, cerrahi, onkoloji, low anterior rezeksiyon

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