Artikel
Anorectal function and quality of life after transrectal hybrid-NOTES sigmoidectomy for diverticular disease
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Autoren
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Daniel Steinemann
- Standort Bruderholz, Kantonsspital Baselland, Klinik für Chirurgie, Bruderholz, Switzerland
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Andreas Zerz
- Standort Bruderholz, Kantonsspital Baselland, Klinik für Chirurgie, Bruderholz, Switzerland
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Sara Germann
- Standort Bruderholz, Kantonsspital Baselland, Klinik für Chirurgie, Bruderholz, Switzerland
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Sebastian Lamm
- Standort Bruderholz, Kantonsspital Baselland, Klinik für Chirurgie, Bruderholz, Switzerland
| Veröffentlicht: | 21. April 2016 |
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Gliederung
Text
Background: Anorectal function and quality of life after transrectal hybrid-NOTES sigmoidectomy (trNS) is not investigated so far.
Materials and methods: Preoperative, 3 and 6 months postoperative assessment by anorectal manometry, questionnaires on continence, defecation, gastrointestinal quality of life index (GIQLI, range 0 – 144) and sexual health inventory for men (SHIM, 0 – 25) was performed from november 2013 until october 2014.
Results: In 20 patients (19 men) resting pressure tended to decline from 56 (41-76) to 46 (36-56) mmHg at 6 months (p=0.072); squeeze pressure and rectal capacity remained unchanged. Preoperative Vaizey-Wexner score remained steady (preoperative 0 (0-4); 3 months 0 (0-2); 6 months 0 (0-1); p=0.78). Stool frequency increased from 2 (1-3) to 3 (2-4) (p=0.036) after 3 and normalized to 2 (1-3) after 6 months (p=0.66). The proportion of patients with occasional incomplete evacuation was unchanged (35% preoperative, 40% at 6 months). The GIQLI improved from 123 (119-130) to 137 (131-141) within 6 months (p=0.033). The SHIM remained equal (preoperative 23 (11-25), 6 months 24 (19-25)).
Conclusion: TrNS does not impair clinical continence. Though, the resting pressure tended to be decreased until 6 months postoperatively. The quality of life was excellent and improved after 6 months whereas sexuality is not affected.
