摘要
目的探讨溃疡性结肠炎(ulcerative colitis,UC)和家族性腺瘤性息肉病(familial adenomatous polyposis,FAP)患者行腹腔镜全结直肠切除及回肠储袋肛管吻合(ileal pouch anal anastomosis,IPAA)术后性功能、排尿功能及生活质量状况。方法回顾性分析2006年1月至2018年9月在武汉大学中南医院接受IPAA手术治疗的45例UC和FAP患者的临床资料及随访信息,通过问卷量表评估术后性功能、排尿功能及生活质量,并分析相关影响因素。结果45例患者中UC 18例,FAP 27例;行一期手术5例,二期手术37例,三期手术3例;开腹手术13例,腹腔镜手术32例。IPAA术后发生性功能障碍7例,男性与女性、UC与FAP、一期、二期、三期手术差异均无统计学意义(均P>0.05),而开腹组与腹腔镜组差异有统计学意义(P=0.025)。术后发生排尿功能障碍6例,男性与女性、UC与FAP、一期、二期、三期手术差异均无统计学意义(均P>0.05),开腹组与腹腔镜组差异有统计学意义(P=0.007)。45例患者术后克利夫兰生活质量评分量表评分为0.696±0.085,男性与女性、UC与FAP、一期、二期、三期手术、开腹组与腹腔镜组的克利夫兰生活质量评分量表评分差异均无统计学意义(均P>0.05),而术后生活质量与接受手术时的年龄有关(P=0.001)。结论与开腹手术相比,腹腔镜全结直肠切除及回肠储袋肛管吻合术后患者的性功能和排尿功能状况更好。
Objective To investigate the sexual function,urinary function and quality of life in patients of ulcerative colitis(UC)and familial adenomatous polyposis(FAP)after total proctocolectomy and ileal pouch anal anastomosis(IPAA).Methods The clinical data of patients with UC and FAP undergoing IPAA at Zhongnan Hospital of Wuhan University from Jan 2006 to Sep 2018 were reviewed,postoperative sexual function,urinary function,and long-term quality of life were assessed.Results There were 45 patients with median age of 35 years,median follow-up time of 31 months.18 were UC,27 were FAP,5 did 1-stage surgery,37 did 2-stage surgery,3 for 3-stage surgery,13 underwent open surgery,and 32 underwent laparoscopic surgery.7 patients suffered sexual dysfunction after IPAA,and there was no statistical difference between male and female(P=0.992),UC and FAP(P=0.153),1-stage,2-stage,and 3-stage surgery(P=0.363),with statistically significant difference between the open group and the laparoscopic group(P=0.025).6 patients complicated with urinary dysfunction after IPAA,and there was no statistical difference between male and female(P=0.562),UC and FAP(P=0.325),1-stage,2-stage,and 3-stage surgery(P=0.286),with statistically significant difference between the open group and the laparoscopic group(P=0.007).The Cleveland Global Quality of Life(CGQL)score after IPAA was 0.696±0.085.There were no statistical difference on CGQL scores in males and females(P=0.635),UC and FAP(P=0.664),1-stage,2-stage,and 3-stage(P>0.05),open group and laparoscopic group(P=0.205),postoperative long-term QOL was significantly associated only with age at the time of surgery(P=0.001).Conclusions Compared with open surgery,laparoscopic TPC-IPAA patients had better postoperative sexual function and urination function.
作者
陈保祥
孙孔亮
洪云天
刘波
喻学桥
丁召
钱群
江从庆
赵秋
黄梅芳
叶梅
尹同治
叶辉
Chen Baoxiang;Sun Kongliang;Hong Yuntian;Liu Bo;Yu Xueqiao;Ding Zhao;Qian Qun;Jiang Congqing;Zhao Qiu;Huang Meifang;Ye Mei;Yin Tongzhi;Ye Hui(Department of Colorectal and Anal Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071 China;Qianjiang Central Hospital,Qianjiang 433100 China;Jingzhou Central Hospital,Jingzhou,434000 China)
出处
《中华普通外科杂志》
CSCD
北大核心
2019年第11期959-963,共5页
Chinese Journal of General Surgery
关键词
性功能障碍
生理性
排尿障碍
吻合术
外科
Sexual dysfunction
physiological
Urination disorders
Anastomosis
surgical
