Comprehensive Evaluation of Quality of Life in Proximal Rectal Cancer Patients

Hourani I. F., Bondarenko M. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The aim of the research was to conduct a comprehensive evaluation of QOL of proximal rectal cancer patients depending on the volume of executed operations. Materials and methods. A total of 329 proximal rectal cancer patients. Among them there were 162 men (49,2 ± 1,2 %) and 167 (50,8 ± 1,2 %) women. Patients were divided as follows: group I (n = 95 ) (28,9 ± 1,1 %) – patients, who had tumor process complica­ tions; group II (n = 234 ) (71,1 ± 1,4 %) – patients, who had no complications. We analyzed the frequency of the main disease stages and found that the most frequent was stage II – 52,3 ± ,3 %, Stage III – 28,3 ± 1,3 %, stage IV – 13,6 ± 0,9, and stage I – 5,8 ± 0,6 %. One­stage operations were performed on 287 patients. Surgeries with renovation of intestine integrity after the Hartmann’s operation (HO) were performed on 42 patients. Patients were divided as follows: patients who underwent anterior resection (AR) – n = 104 (31,6 ± 3,4 %); abdominoperineal resection (APR) – n = 102 (31,0 ± 4,3 %), abdomi­ nal­nadanal resection (ANR) – n = 46 (14,0 ± 3,1 %). Duhamel operation (Dо) – on 35 patients (10,6 ± 3,5 %), HO with the following renovation of intestine integrity, as the second phase, was performed on 42 patients (12,8 ± 2,1 %). Results and discussion. Factor (PF) in patients was after AR – 47,1 ± 6,4 points, APR – 33,8 ± 5,9, ANR – 42,6 ± 6,3, DO – 43,4 ± 5,1. Index (RP) was after AR – 48,3 ± 5,6, APR – 34,7 ± 6,1, ANR – 43,7 ± 5,9, DO – 44,2 ± 5,8. Index (BP) was after APR – 51,5 ± 4,7, AR – 41,9 ± 4,8, ANR – 48,7 ± 5,1, DO – 45,9 ± 4,8 points. Index (GH) was after AR – 46,3 ± 6,0, APR – 36,5 ± 5,6, ANR – 43,7 ± 5,5, DO – 44,0 ± 5,9. In the analysis of the indices (VT), it was found that after AR after it was 58,3 ± 5,7, APR – 48,1 ± 5,5, ANR – 53,2 ± 5,5, DO – 56,9 ± 4,8 points. Index (SF) was after AR 61,3 ± 6,4, APR – 51,7 ± 5,8, ANR – 57,4 ± 5,9, DO – 58,1 ± 5,6 points. Index (RW) in patients was after AR 41,7 ± 5,8, APR – 23,2 ± 6,1, ANR – 29,3 ± 5,5, DO – 35,7 ± 5,7. During evalu­ ation of index (PH) it was found that it was after AR 43,2 ± 6,9, APR – 37,4 ± 6,6, ANR – 39,4 ± 6,6, DO – 41,8 ± 5,7 points. Index (MH) was after AR 43,7 ± 5,5, APR – 35,9 ± 4,7, ANR – 36,6 ± 4,9, DO – 39,6 ± 5 points. We conducted a comparative analysis of QOL evaluation depending on the operation phase and obtained the following results: index (PF) after one­stage operations with renovation of intestine integrity was 45,7 ± 6,1, two­ stage operations – 30,6 ± 5,7 points. Index (RP) after a one­stage operation was 46,9 ± 5,8, after two­stage operations – 31,9 ± 6,2. Index (BP) after two­stage operations was 55,8 ± 4,9, after a one­stage operation – 42,6 ± 4,7. Index (GH) during one­stage opera­ tions was 45,5 ± 6,1 points, in patients, who underwent two­stage operations, this index was 31,7 ± 5,4. Index (VT) after one­stage operations was 57,6 ± 5,9, after two­stage operations – 43,1 ± 5,7. Index (SF) after one­stage operations amounted to 60,2 ± 6,3, after two­stage operations – 49,7 ± 5,5 points. Index (RW) after one­stage operations was 40,4 ± 5,3, after two­stage operations – 20,3 ± 5,4. Index (PH) after one­stage operations was 42,6 ± 6,2, after two­stage operations – 33,9 ± 6,1. Index (MH) after one­stage opera­ tions was 41,8 ± 5,4 and 31,7 ± 4,9 after two­stage operations. Conclusions. QOL indices of proximal rectal cancer patients, undergoing one­stage operations, were the best in 10 years after anterior resection and the worst after abdominoperineal resection. The worst indices of QOL were in patients after Hartmann’s operation with the following bowel integrity restoration of the second stage surgical treatment of the proximal rectal cancer.

rectal cancer, Hartmann’s operation, one­stage operation, quality of life

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