Zusammenfassung
EINLEITUNG: Derzeit besteht ein Mangel an Studien, die den Einfluss einer Anastomosendehiszenz nach Rektumkarzinomresektion auf die Beckenbodenfunktion und Lebensqualität untersucht haben. METHODIK: Zwischen 1995 und 2006 wurde an einem Institut bei 500 Patienten mit einem Rektumkarzinom eine Rektumresektion durchgeführt. Sechsunddreißig Patienten (7.2%) entwickelten eine Anastomosendehiszenz nach der Operation. Davon verstarben 15 Patienten (41.6%) in der Nachbeobachtungszeit. Ein standardisierter Fragebogen, welcher den International Index of Erectile Function, Female Sexual Function Index, Short Form-12 Health Survey, International Prostatic Symptom Score, International Consultation on Incontinence Questionnaire-Short Form, Vaizey Incontinence Score und Wexner Constipation Score inkludierte, wurde an alle 21 lebenden Patienten geschickt. Patienten mit einer Rektumkarzinomresektion ohne postoperativer Dehiszenz dienten als Kontrollen für jeden Fall und wurden gematcht nach Geschlecht, Alter (±5), Art der Resektion und neoadjuvanten Therapie (Ja/Nein). ERGEBNIS: Sechzehn Patienten (76.2%) waren verfügbar und wurden in die Analyse einbezogen. Stuhlinkontinenz, Verstopfung und sexuelle Funktion zeigten keinen Unterschied zwischen Patienten und Kontrollgruppe (p = 0,1973, 0,1189, 0,8519). Allerdings war die Harnkontinenz signifikant beeinträchtigt bei jenen Patienten mit Anastomosendehiszenz (p = 0,0430). Die Lebensqualität zeigte keinen signifikanten Unterschied zwischen den beiden Gruppen (p = 1,0000 und 0,1973). ZUSAMMENFASSUNG: Eine Anastomosendehiszenz nach Rektumkarzinomresektion führt zu einer deutlichen Beeinträchtigung der Harnkontinenz. Stuhlinkontinenz, sexuelle Funktion, Verstopfung und Lebensqualität sind vergleichbar zwischen Patienten mit und ohne Anastomosendehiszenz.
Summary
INTRODUCTION: There is a paucity of studies assessing the influence of anastomotic leakage after rectal cancer surgery on pelvic organ function and quality of life. METHODS: Between 1995 and 2006, 500 patients underwent rectal resection for malignancies at a single institution. Thirty-six patients (7.2%) developed an anastomotic leakage postoperatively. Fifteen of these patients (41.6%) died during the follow-up period. A self-administering questionnaire including the International Index of Erectile Function, Female Sexual Function Index, Short Form-12 Health Survey, International Prostatic Symptom Score, International Consultation on Incontinence Questionnaire-Short Form, Vaizey Incontinence Score and Wexner Constipation Score was sent to all 21 alive patients. Patients with rectal cancer resection without leakage served as controls for each case and were matched by sex, age (±5 years), type of resection, and neoadjuvant therapy (yes/no). RESULTS: Sixteen patients (76.2%) were available and were included in the analysis. The median follow-up time was 106.8 months (32.4–170.4). Fecal incontinence, constipation, and sexual function did not differ significantly between patients and controls (p = 0.1973, 0.1189, 0.8519, respectively). By contrast, urinary continence was impaired significantly in the leakage group (p = 0.0430) but not in control patients. The Quality of Life assessing Short Form-12 Health Survey reached no significant difference between both groups (p = 1.0000 and 0.1973). CONCLUSION: Anastomotic leakage following anterior resection negatively aggravates urinary function but not fecal incontinence, constipation or sexual functions. The data indicate that patients experiencing anastomotic leakages can be relieved from the fear of gross pelvic floor function disturbances.
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Riss, S., Stremitzer, S., Riss, K. et al. Pelvic organ function and quality of life after anastomotic leakage following rectal cancer surgery. Wien Klin Wochenschr 123, 53–57 (2011). https://doi.org/10.1007/s00508-010-1514-y
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DOI: https://doi.org/10.1007/s00508-010-1514-y