Patient-Reported Bowel, Urinary, and Sexual Outcomes After Laparoscopic-Assisted Resection or Open Resection for Rectal Cancer The Australasian Laparoscopic Cancer of the Rectum Randomized Clinical Trial (ALaCart)

被引：11

作者：

Mercieca-Bebber, Rebecca ^{[1
,2
]}

Eggins, Renee ^{[1
,2
]}

Brown, Kilian ^{[3
]}

Gebski, Val J. ^{[1
,2
]}

Brewer, Kate ^{[2
]}

Lai, Lenna ^{[1
,2
]}

Bailey, Lisa ^{[1
,2
]}

Solomon, Michael J. ^{[3
]}

Lumley, John W. ^{[4
]}

Hewett, Peter ^{[5
]}

Clouston, Andrew D. ^{[6
,7
]}

Wilson, Kate ^{[1
,2
]}

Hague, Wendy ^{[1
,2
]}

Hayes, Julian ^{[8
]}

White, Stephen ^{[9
,10
]}

Morgan, Matt ^{[11
,12
,13
]}

Simes, R. John ^{[1
,2
]}

Stevenson, Andrew R. L. ^{[1
,6
]}

机构：

[1] Univ Sydney, NHMRC Clin Trials Ctr, Sydney, NSW, Australia

[2] Univ Sydney, Royal Prince Alfred Hosp, Australasian Gastrointestinal Trials Grp, Sydney, NSW, Australia

[3] Univ Sydney, Royal Prince Alfred Hosp, Inst Acad Surg, Sydney, NSW, Australia

[4] Wesley Hosp, Brisbane, Qld, Australia

[5] Queen Elizabeth Hosp, Adelaide, SA, Australia

[6] Univ Queensland, Brisbane, Qld, Australia

[7] Royal Brisbane & Womens Hosp, Brisbane, Qld, Australia

[8] Auckland Hosp, Auckland, New Zealand

[9] John Flynn Hosp, Auckland, Qld, Australia

[10] Tweed Heads Hosp, Tweed Heads, NSW, Australia

[11] Bankstown Lidcombe Hosp, Sydney, NSW, Australia

[12] Prince Wales Private Hosp, Sydney, NSW, Australia

[13] Sydney South West Private Hosp, Sydney, NSW, Australia

来源：

ANNALS OF SURGERY | 2023年 / 277卷 / 03期

基金：

澳大利亚国家健康与医学研究理事会; 英国医学研究理事会;

关键词：

clinical trial; laparoscopic surgery; laparoscopic-assisted rectal cancer resection; open rectal cancer resection; patient-reported outcomes; quality of life; rectal cancer; sexual functioning; OPEN SURGERY; TERM OUTCOMES; INDEX FSFI; LIFE;

D O I：

10.1097/SLA.0000000000005412

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Objective: The aim of this study was to compare patient-reported urinary, bowel, and sexual functioning of ALaCaRT Trial participants randomized to open or laparoscopic surgery for rectal cancer. Summary Background Data: The primary endpoint, noninferiority of laparoscopic surgical resection adequacy, was not established. Methods: Participants completed QLQ-CR29 at baseline, 3, and 12 months post-surgery. Additionally, women completed Rosen's Female Sexual Functioning Index (FSFI). Men completed the International Index of Erectile Function (IIEF) and QLQ-PR25. We compared the proportions of participants in each group who experienced moderate/severe symptoms/dysfunction at each time-point and compared mean difference scores from baseline to 12 months between groups. All analyses were intention-to-treat. Sexual functioning analyses included only the participants who expressed sexual interest at baseline. Results: Baseline PRO compliance of 475 randomized participants was 88%. At 12 months, a lower proportion of open surgery participants experienced moderate-severe fecal incontinence and sore skin, compared to Laparoscopic participants, and a lower proportion of men randomized to open surgery experienced moderate-severe urinary symptoms. There were no differences at 3 months for bowel or urinary symptoms. Sexual functioning among sexually interested participants was similar between groups at 3 and 12 months; however, a lower proportion of women reported moderate to severe sexual dissatisfaction at 3 months in the open as compared to the laparoscopic group, (Rebecca.mercieca@sydney.edu.au., 95% CI 0.03-0.39). Discussion: Despite the slightly lower proportions of open surgery participants self-reporting moderate-severe symptoms for 3 of 16 urinary/bowel domains, and lack of differences in sexual domains, it remains difficult to recommend one surgical approach over another for rectal resection.

引用

页码：449 / 455

页数：7

共 21 条

[1]

Ambler Dana R, 2012, Rev Obstet Gynecol, V5, P16

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