肠道深部子宫内膜异位症机器人切除术后的患者报告结局
Patient-Reported Outcomes after Robotic Resection of Deep Endometriosis of the Bowel
摘要
单中心回顾性队列研究,纳入2018年1月至2023年10月在一家学术三级中心接受多学科机器人切除的肠道深部子宫内膜异位症患者。92例符合条件者中,41例完成术前及至少一次术后功能结局问卷(数字评分量表)。总体疼痛由术前5.3±2.7降至术后6个月最低点1.6±1.9、12个月2.3±3.0(p<0.001);排卵期、经前、经期及经后疼痛在术后12个月均降至均值约1(p<0.001);疼痛影响工作的比例由88%降至<40%;对肠道功能满意的比例由39%升至6个月80.0%、12个月69.2%(p=0.014)。局限为12个月应答率仅31.7%、单中心、人群多样性低及回顾性设计。
原文摘要
BACKGROUND: While minimally invasive surgery is the current surgical standard of care for excision of deep endometriosis of the bowel, there is little literature evaluating patient-reported outcome measures following a multidisciplinary, robotic approach. OBJECTIVE: This study aimed to assess the functional outcomes of robotic surgery for patients undergoing resection of deep endometriosis involving the bowel. DESIGN: Retrospective cohort review. SETTINGS: A single academic tertiary institution. PATIENTS: Patients with endometriosis of the bowel undergoing multidisciplinary resection between January 1, 2018, and October 1, 2023. MAIN OUTCOME MEASURES: A survey assessing functional outcomes on a Numeric Rating Scale preoperatively and at multiple points postoperatively. RESULTS: Of 92 eligible patients, 41 completed a preoperative survey and at least one postoperative survey. Among these 41 patients, overall pain improved postoperatively from 5.3 ± 2.7 (Numeric Rating Scale) to a nadir of 1.6 ± 1.9 at 6 months and 2.3 ± 3.0 at 12 months (p < 0.001). Preoperative pain at ovulation (mean 4.2 Numeric Rating Scale ± 3.7), pre-period pain (4.9 ± 3.5), period pain (5.7 ± 3.6) and post-period pain (3.3 ± 3.3) all decreased to a mean of 1 at 12 months postoperatively (p < 0.001). The proportion of patients reporting pain impacting work decreased from 88% preoperatively to <40% postoperatively (p < 0.001). The proportion of patients happy with their bowel function increased from 39% preoperatively to 63.2% at 1 month, 80.0% at 6 months, and 69.2% at 12 months postoperatively (p = 0.014). LIMITATIONS: Only 31.7% of patients responded to their 12-month survey, tertiary care center, low diversity in patient demographics, retrospective design. CONCLUSION: In this cohort of patients undergoing multi-disciplinary robotic excision for advanced endometriosis involving the bowel, patients reported significantly improved pain and quality of life measures. See Video Abstract.
推荐理由:提供了多学科机器人切除肠道深部内异症的术后功能与生活质量数据,对手术决策与患者咨询有参考价值;但样本小、应答率低、单中心回顾性,且不涉及生育或ART结局,与生殖医学核心关联有限。
文献解读
尚未生成。