Cem Batuhan Ofluoglu, Isa Caner Aydin, Yunus Emre Altuntas, Kenan Cetin, Rahsan Inan, Noyan Ilhan, Firat Mulkut, Hasan Fehmi Kucuk
{"title":"盆底肌肉训练对低位前切除术患者括约肌功能和生活质量的影响：比较评估","authors":"Cem Batuhan Ofluoglu, Isa Caner Aydin, Yunus Emre Altuntas, Kenan Cetin, Rahsan Inan, Noyan Ilhan, Firat Mulkut, Hasan Fehmi Kucuk","doi":"10.14744/nci.2024.37786","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Our study aimed to determine the impact of pelvic floor muscle training (PFMT) on sphincter function and overall well-being in patients who underwent low anterior resection (LAR) and diverting ileostomy due to rectal cancer. For this purpose, anal electromyography (aEMG), low anterior resection syndrome (LARS) score, and the European Organization for Research and Treatment of Cancer quality-of-life questionnaires (EORTC-QLQ)-C30 (generic for cancer) and CR29 (specific to colorectal cancer) were used. The primary endpoint of our study is to determine the effect of PFMT on sphincter function by aEMG, the secondary endpoint is to evaluate the effect on quality-of-life using the LARS score, EORTC-QLQ-C30 and CR-29 questionnaires.</p><p><strong>Methods: </strong>Conducted between January 2017 and April 2018 at a tertiary hospital's general surgery clinic, the study included 32 patients between the ages of 18 and 75 who underwent low anterior resection and diverting ileostomy surgery. The patients were divided into two: the Study Group (SG), which started PFMT after surgery, and the Control Group (CG), which was not subjected to additional exercises. Six months after closure of the diverting ileostomy, both groups were evaluated with aEMG, LARS scores, and EORTC-QLQ-C30 and CR-29.</p><p><strong>Results: </strong>aEMG duration values were significantly lower in the SG (17.6 m/sec vs. 19.9 m/sec; p=0.001). Additionally, a significant decrease in SG, major LARS rates (12.5% vs. 62.5%; p=0.004) and LARS scores (23.1 vs. 30.0; p=0.003) was observed. While there was no significant difference between the groups in EORTC-QLQ C30, increased sexual interest and decreased fecal incontinence were observed in SG in EORTC-QLQ-CR29.</p><p><strong>Conclusion: </strong>PFMT significantly improves LARS scores, quality-of-life questionnaires and aEMG parameters, positioning PFMT as an accessible, non-invasive, easy-to-use first-line treatment option in the treatment of LARS.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 4","pages":"336-342"},"PeriodicalIF":0.0000,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331206/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of pelvic floor muscle training on sphincter function and quality-of-life in patients who underwent low anterior resection: A comparative evaluation.\",\"authors\":\"Cem Batuhan Ofluoglu, Isa Caner Aydin, Yunus Emre Altuntas, Kenan Cetin, Rahsan Inan, Noyan Ilhan, Firat Mulkut, Hasan Fehmi Kucuk\",\"doi\":\"10.14744/nci.2024.37786\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Our study aimed to determine the impact of pelvic floor muscle training (PFMT) on sphincter function and overall well-being in patients who underwent low anterior resection (LAR) and diverting ileostomy due to rectal cancer. For this purpose, anal electromyography (aEMG), low anterior resection syndrome (LARS) score, and the European Organization for Research and Treatment of Cancer quality-of-life questionnaires (EORTC-QLQ)-C30 (generic for cancer) and CR29 (specific to colorectal cancer) were used. The primary endpoint of our study is to determine the effect of PFMT on sphincter function by aEMG, the secondary endpoint is to evaluate the effect on quality-of-life using the LARS score, EORTC-QLQ-C30 and CR-29 questionnaires.</p><p><strong>Methods: </strong>Conducted between January 2017 and April 2018 at a tertiary hospital's general surgery clinic, the study included 32 patients between the ages of 18 and 75 who underwent low anterior resection and diverting ileostomy surgery. The patients were divided into two: the Study Group (SG), which started PFMT after surgery, and the Control Group (CG), which was not subjected to additional exercises. Six months after closure of the diverting ileostomy, both groups were evaluated with aEMG, LARS scores, and EORTC-QLQ-C30 and CR-29.</p><p><strong>Results: </strong>aEMG duration values were significantly lower in the SG (17.6 m/sec vs. 19.9 m/sec; p=0.001). Additionally, a significant decrease in SG, major LARS rates (12.5% vs. 62.5%; p=0.004) and LARS scores (23.1 vs. 30.0; p=0.003) was observed. 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引用次数: 0
摘要
研究目的我们的研究旨在确定盆底肌肉训练（PFMT）对因直肠癌接受低位前切除术（LAR）和分流回肠造口术的患者的括约肌功能和整体健康的影响。为此，我们使用了肛门肌电图（aEMG）、低位前切除综合征（LARS）评分以及欧洲癌症研究和治疗组织生活质量问卷（EORTC-QLQ）-C30（癌症通用问卷）和 CR29（结直肠癌专用问卷）。我们研究的主要终点是通过肌电图确定 PFMT 对括约肌功能的影响，次要终点是使用 LARS 评分、EORTC-QLQ-C30 和 CR-29 问卷评估对生活质量的影响：研究于 2017 年 1 月至 2018 年 4 月在一家三甲医院的普外科门诊进行，纳入了 32 名年龄在 18 岁至 75 岁之间、接受低位前切除术和回肠造口改道手术的患者。患者被分为两组：研究组（SG）和对照组（CG），前者在手术后开始进行 PFMT，后者则不进行额外的锻炼。结果：研究组的肌电图持续时间值显著低于对照组（17.6 米/秒 vs. 19.9 米/秒；P=0.001）。此外，还观察到 SG、主要 LARS 发生率（12.5% vs. 62.5%；p=0.004）和 LARS 评分（23.1 vs. 30.0；p=0.003）明显下降。虽然两组在 EORTC-QLQ C30 中没有明显差异，但在 EORTC-QLQ-CR29 中观察到 SG 的性兴趣增加，大便失禁减少：结论：PFMT 能明显改善 LARS 评分、生活质量问卷调查和 aEMG 参数，是治疗 LARS 的一种方便、无创、易用的一线治疗方案。
Impact of pelvic floor muscle training on sphincter function and quality-of-life in patients who underwent low anterior resection: A comparative evaluation.
Objective: Our study aimed to determine the impact of pelvic floor muscle training (PFMT) on sphincter function and overall well-being in patients who underwent low anterior resection (LAR) and diverting ileostomy due to rectal cancer. For this purpose, anal electromyography (aEMG), low anterior resection syndrome (LARS) score, and the European Organization for Research and Treatment of Cancer quality-of-life questionnaires (EORTC-QLQ)-C30 (generic for cancer) and CR29 (specific to colorectal cancer) were used. The primary endpoint of our study is to determine the effect of PFMT on sphincter function by aEMG, the secondary endpoint is to evaluate the effect on quality-of-life using the LARS score, EORTC-QLQ-C30 and CR-29 questionnaires.
Methods: Conducted between January 2017 and April 2018 at a tertiary hospital's general surgery clinic, the study included 32 patients between the ages of 18 and 75 who underwent low anterior resection and diverting ileostomy surgery. The patients were divided into two: the Study Group (SG), which started PFMT after surgery, and the Control Group (CG), which was not subjected to additional exercises. Six months after closure of the diverting ileostomy, both groups were evaluated with aEMG, LARS scores, and EORTC-QLQ-C30 and CR-29.
Results: aEMG duration values were significantly lower in the SG (17.6 m/sec vs. 19.9 m/sec; p=0.001). Additionally, a significant decrease in SG, major LARS rates (12.5% vs. 62.5%; p=0.004) and LARS scores (23.1 vs. 30.0; p=0.003) was observed. While there was no significant difference between the groups in EORTC-QLQ C30, increased sexual interest and decreased fecal incontinence were observed in SG in EORTC-QLQ-CR29.
Conclusion: PFMT significantly improves LARS scores, quality-of-life questionnaires and aEMG parameters, positioning PFMT as an accessible, non-invasive, easy-to-use first-line treatment option in the treatment of LARS.
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