Effects Of Transanal Total Mesorectal Excision On Patients’ Quality Of Life And Organ Function

Objective:To explore the effect of transanal total mesorectal excision(taTME)on quality of life and organ function of patients.Methods:A retrospective case series study was conducted to collect the clinical data of rectal cancer patients who underwent transanal total mesorectal excision from July 2018 to may 2019 in the Department of gastrointestinal surgery,Nanchong Central Hospital Affiliated to North Sichuan Medical College.The quality of life,urinary function and defecation function of the patients were analyzed.The quality of life was evaluated by EORCT QLQ-C30,the urinary function was evaluated by IPSS,and the defecation function was evaluated by LARS.Preoperative and postoperative 1 month and 6 months were compared.Results:A total of 42 patients were included in this study.(1)In terms of quality of life,physical function,role function,pain and global health status decreased at 1 month after operation,and the differences were statistically significant(P<0.05);Except for role function,they all recovered to the preoperative level 6 months after operation(P>0.05).(2)In terms of urinary function,there was no significant difference in the incidence of urinary dysfunction among the three time points(χ2=1.089,P>0.05).(3)There was no significant difference in the incidence of minor LARS among the three time points(χ2=0.389,P>0.05).The incidence of major LARS at 1 month after operation was significantly higher than that before operation(χ2=30.612,P<0.05).The incidence of major LARS at 6 months after operation was lower than that at 1 month after operation,and the difference was not statistically significant(χ2=1.867,P>0.05).The incidence of incontinence for flatus at 1 month after operation was significantly higher than that before operation(χ2=33.402,P<0.05),which was significantly lower at 6 months after operation than at 1 month after operation(χ2=9.450,P<0.05);1 month after operation,the incidence of incontinence for liquid stools was significantly higher than that before operation(χ2=23.259,P<0.05),which decreased 6 months after operation compared with 1 month after operation,and the difference was not statistically significant(χ2=3.231,P>0.05),The incidence of frequency bowel,clustering of stools and urgency at 1 month after operation was higher than that before operation,and the difference was statistically significant(χ2=1.8.018,0.741,12.444,P<0.05).There was no significant change at 6 months after operation(χ2=0.091,0.000,0.246,P>0.05).Correlation analysis showed that there was no correlation between transanal operation time and LARS at 1 month and 6 months(r=0.026,-0.024,P>0.05).Conclusion:The effect of taTME on patients’ life is limited and reversible,and it has no significant effect on urinary function.There was no correlation between transanal operation time and defecation function,and the postoperative defecation function of patients will not become worse because of the extension of transanal operation time.The incidence of LARS after taTME is still high,which decreases within 6 months after operation,but is still higher than that before operation.At least 6 months after operation is the best time for anal rehabilitation training.Close attention should be paid to the defecation of patients and necessary intervention should be provided.