| ObjectiveTo evaluate accurately and objectively quality of life of the patients and their suffering and inconvenience after abdominoperineal resection with colostornies and to compare the short and long term functional control of two methods of colostomies, the difference of operative complications, colostomy function of controlling excrement in postoperative half year and one year, degree of patient satisfaction were compared.MethodsThe study was conducted on 84 patients who underwent abdominoperineal resection with colostomies between ^990 and 2000 years in the Second Affiliated Hospital., Zhejiang University College of Medicine and the Longyou People Hospital and were survival disease-free for more than one year.1. Questionary was formulated by the means to assess the functions of permanent abdominal colostomy That included objective and subjective questions. Seven objective questions were (l)excretory intention, (2)interval times from occurring excretory intention to excreting, (S)function of continence, (4) sensibility of excreting, (5)excreting frequency, (6)excreting time and (7) whether clothes would be polluted if artificial anal bag were not used. Theevaluation was conducted according tc three degree. The subjective question is the degree of patient satisfaction to the artificial anus. It was divided into ten degree.2. The data of the patients was acquired from the medical record. It included the name, gender, age, occupation, address, diagnose, operative date, operative time, means of colostciny, hemorrhage volume, time of first excreting gas or excrement, postoperative time in hospital, postoperative complication and re-operation if their was.3. The questionnaries was collected from patients half year and one year post opreatively respectively Follow-up was performed with mail, telephone or personal interview directly The patients and interviewer are double blind in the follow-up4. The SPSS 8.0 software was used for statistics management. Results1. There were actually 84 cases qualified in the study from total 189 cases Forty-five patients were in extraperitoneal colostomy group and 39 in intraperitoneal colostomy. The general material of two groups were comparable in X: test and T test with a P >0.05.2. There were no difference between two groups on hemorrhage volume, operative time, time of first excreting gas or excrement, postoperative time in hospital.3. Seventeen patients had postoperative complications in 84 patients (20.24%) Four patients had colostomy complications (4 76%, all in intrapentoneal groups) and 13 patients had common complications (15.48%, 9 in intraperitoneal group and 4 in extraperitoneal group). The incidence of general complication and the colostomy complication of intraperitoneal groups were higher than that of extraperitoneal group. There was no difference of the incidence of commoncomplication and complication types between two groups.4. At half postoperative year, the mean Ridit value of two groups was similar. There was no statistics difference between two groups.5. At one postoperative year, the scores of extraperitoneal group are better than intraperitoneal group in all 7 objective assessments The patient's degree of satisfaction to the colostomy was also higher in the extraperitoneal group than in the intraperitoneal group (P<0.01),6. The function of the colostomy gets improvement with the time in both groups. But the extent of functional improvement are more in extraperitoneal colostomy group than that of intraperitoneal group. The improvement are on the aspect of interval times from occurring to excretory intention to excreting, function of continence, whether clothes would be polluted if artificial anal bag were not used and degree of patient satisfaction tc the colostomy but not on other aspectConcludeIn a series of 84 patients followed for ai least a year after abdominoperineal excision for carcinoma of the rectum, extra...
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