腹腔镜和开腹手术治疗直肠癌患者的直肠功能及性功能对比研究  

Comparative study of rectal function and sexual function in patients with rectal cancer treated by laparoscopy and laparotomy

作　　者：袁泉良[1] YUAN Quan-liang(Department of Anorectal,Nanyang Central Hospital,Nanyang,Henan 473009,China)

机构地区：[1]南阳市中心医院肛肠科,河南南阳473009

出　　处：《医药论坛杂志》2024年第9期958-964,共7页Journal of Medical Forum

摘　　要：目的对比腹腔镜手术(laparoscopic resection,LR)或开腹手术(open resection,OR)患者术后直肠功能和性功能。方法应用前瞻性究方法。选取2020年7月—2022年6月在南阳市中心医院进行手术治疗的直肠癌患者216例,在术前分为LR组和OR组。所有调查对象在术前3d和术后12个月进行问卷调查。对比分析两组患者术后直肠功能和性功能。结果(1)两组手术前LARS评分比较(P>0.05),手术后LARS评分均明显升高,与术前比较(P<0.05),同时OR组LARS评分为(25.57±1.62)分,低于LR组(30.46±1.87)分(P>0.05)。(2)术后12个月,LR组男性的阴茎勃起(3.71±0.68)分、阴茎插入(3.46±0.65)分、完成性交(3.71±0.58)分、性满足(3.25±0.64)分、性自信(3.20±1.09)分和OR组男性的阴茎勃起(3.66±0.83)分、阴茎插入(3.32±0.71)分、完成性交(3.69±0.66)分、性满足(3.17±0.73)分、性自信(3.04±1.15)分比较,差异无统计学意义(P>0.05);术后12个月,LR组女性的性欲(20.93±2.55)分、性高潮(15.62±1.79)分、性心理(14.62±1.80)分、性交困难(18.49±2.01)分和OR组女性的性欲(20.26±2.69)分、性高潮(15.93±1.72)分、性心理(14.26±1.38)分、性交困难(18.94±2.03)分比较,差异无统计学意义(P>0.05)。结论尽管OR男性患者自我报告的膀胱/直肠障碍低于LR,但是优势轻微,仍然很难推荐一种手术方法完全优于另一种手术。Objective To compare the urinary,intestinal and sexual functions of patients after laparoscopic resection(LR)or open resection(OR).Methods Prospective study was used.216 patients were divided into LR group and OR group before operation.All the subjects were investigated by questionnaire 3 days before operation and 12 months after operation.The sexual function,urinary function and defecation function of the two groups were compared and analyzed.Results①LARS score before operation was compared between the two groups(P>0.05),LARS score after operation was significantly higher than that before operation(P<0.05),and LARS score of OR group was(25.57±1.62),which was significantly lower than that of LR group(30.46±1.87)(P>0.05).②12 months after operation,the penis erection(3.71±0.68),penis insertion(3.46±0.65),completion of sexual intercourse(3.71±0.58),sexual satisfaction(3.25±0.64),sexual confidence(3.20±1.09),and the penis erection(3.66±0.83),penis insertion(3.32±0.71),completion of sexual intercourse(3.69±0.66),sexual satisfaction(3.17±0.73),and sexual confidence(3.04±1.15)of the male in the LR group were compared with those of the male in the OR group,The difference was not statistically significant(P>0.05);At 12 months after operation,there was no statistically significant difference in the scores of libido(20.93±2.55),orgasm(15.62±1.79),sexual psychology(14.62±1.80),sexual difficulty(18.49±2.01)between LR group and OR group(20.26±2.69),orgasm(15.93±1.72),sexual psychology(14.26±1.38),and sexual difficulty(18.94±2.03)(P>0.05).Conclusion Although the self-reported bladder/rectal dysfunction of OR male patients is lower than that of LR,the advantage is slight,and it is still difficult to recommend one surgical method to be completely superior to the other.

关 键 词：腹腔镜 开腹手术 直肠癌 

分 类 号：R735.77[医药卫生—肿瘤]