全顺产和回肠袋-肛门吻合术后患者的性功能、尿功能和生活质量

中华普通外科杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.1007-631X.2019.11.014

Baoxiang Chen, K. Sun, Yuntian Hong, Bo Liu, Xueqiao Yu, Zhao Ding, Qun Qian, Congqing Jiang, Qiu-ya Zhao, Mei-fang Huang, M. Ye, Tong Yin, Huichu Ye

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摘要

目的探讨溃疡性结肠炎(UC)和家族性腺瘤性息肉病(FAP)患者全直结肠切除术和回肠袋肛管吻合术(IPAA)后的性功能、泌尿功能和生活质量。方法回顾2006年1月至2018年9月武汉大学中南医院UC、FAP患者行IPAA的临床资料，评估术后性功能、泌尿功能及长期生活质量。结果45例患者，中位年龄35岁，中位随访时间31个月。UC 18例，FAP 27例，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。7例患者IPAA术后出现性功能障碍，男性与女性、UC与FAP (P=0.153)、一期、二期、三期手术差异无统计学意义(P=0.363)，其中开腹组与腹腔镜组差异有统计学意义(P=0.025)。IPAA术后并发尿功能障碍患者6例，男性与女性、UC与FAP (P=0.325)、1期、2期、3期手术(P=0.286)差异无统计学意义，其中开腹组与腹腔镜组差异有统计学意义(P=0.007)。IPAA后的克利夫兰全球生活质量(CGQL)评分为0.696±0.085。男女CGQL评分(P=0.635)、UC与FAP评分(P=0.664)、1期、2期、3期评分(P < 0.05)、开放组与腹腔镜组评分(P=0.205)差异均无统计学意义，术后长期生活质量仅与手术时年龄相关(P=0.001)。结论腹腔镜TPC-IPAA患者术后性功能和排尿功能优于开放手术。关键词:性功能障碍;生理性;排尿障碍;吻合,手术

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Sexual function, urinary function and quality of life in patients after total proctocolectomy and ileal pouch anal anastomosis

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. Key words: Sexual dysfunction, physiological; Urination disorders; Anastomosis, surgical

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中华普通外科杂志

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