Kolon Kanserli Hastalara Yapılan Kolektomi Sonrası Yaşanılan Sorunların ve Yaşam Kalitesinin Değerlendirilmesi: İki Merkezli Çalışma

Bu makale için 25 Ekim 2024 tarihinde bir düzeltme yayımlandı. https://dergipark.org.tr/tr/pub/thdd/article/1580810

Öz

Amaç: Bu çalışmanın amacı kolon kanserli hastalara yapılan kolektomi sonrası hastaların yaşadıkları sorunların ve yaşam kalitesinin değerlendirilmesidir. Gereç ve Yöntem: Bu çalışma tanımlayıcı türde, prospektif bir çalışma olup, Kasım 2022-Mayıs 2023 tarihleri arasında iki farklı şehirde bulunan bir üniversite hastanesinde yürütüldü. Çalışmanın örneklemini araştırma kriterlerine uyan 35 hasta oluşturdu. Tanımlayıcı Özelliklerini Belirleme Formu ve SF-36 Yaşam Kalitesi Ölçeği kullanıldı. Bulgular: Hastaların %62.9’u kadın, yaş ortalaması 60.45±12.74, %51.4’ü lise mezunudur. Hastaların %60’ı sağ hemikolektomi ameliyatı geçirdiği, %68.6’nın açık cerrahi yöntemiyle ameliyat olduğu, ameliyat sonrası %28.58’ine stoma açıldığı ve ortalama 7.85±1.45 gün hastanede kaldığı belirlendi. Ameliyat sonrası hastaların çoğunlukla yorgunluk, ağrı, ileus ve fistül sorunlarını yaşadığı belirlendi. SF-36 Yaşam Kalitesi Ölçeği alt boyutlarının puan ortalamaları; Fiziksel Fonksiyon 60.85±32.18, Fiziksel Rol Güçlüğü 37.14±40.84, Emosyonel Rol Güçlüğü 43.80±38.57, Enerji 54.57±16.28, Ruhsal Sağlık 60.80±15.11, Sosyal İşlevlik 57.50±22.52, Ağrı 67.78±22.25, Genel Sağlık Algısı 54.14±20.77’dır. Genel sağlık algısı ve ağrı alt boyutları kadınlarda anlamlı derecede yüksektir (p<0.05). Sonuç: Kolektomi ameliyatı sonrası hastaların sorunlar yaşadığı ve yaşam kalitelerinin olumsuz etkilendiği görülmektedir.

Anahtar Kelimeler

• Ameliyat sonrası sorunlar
• kolektomi
• kolon kanseri
• yaşam kalitesi

Evaluation of Problems Experienced and Quality of Life After Colectomy in Colon Cancer Patients: A Two-Center Study

Bu makale için 25 Ekim 2024 tarihinde bir düzeltme yayımlandı. https://dergipark.org.tr/tr/pub/thdd/article/1580810

Öz

Objective: The aim of this study was to evaluate the problems and quality of life of patients with colon cancer after colectomy. Method: This study is a descriptive, prospective study and was conducted at a university hospital in two different cities between November2022 and May2023. The sample of study consisted of 35 patients who met the criteria. The Descriptive Characteristics Form and SF-36 Quality of Life Scale were used. Results: The patients of 62.9% are female, the average age is 60.45±12.74, and 51.4% are high school graduates. It was determined that 60% of patients had right hemicolectomy surgery, 68.6% had open surgery, 28.58% had a stoma after the surgery, they stayed in hospital for an average of 7.85±1.45 days. It was determined that postoperatively, patients mostly experienced fatigue, pain, ileus and fistula problems. Score averages of SF-36 Quality of Life Scale subscales; Physical Function 60.85±32.18, Physical Role Difficulty 37.14±40.84, Emotional Role Difficulty 43.80±38.57, Energy 54.57±16.28, Mental Health 60.80±15.11, Social Functioning 57.50±22.52, Pain 67.78±22.25, General Health Perception 54.14 is ±20.77. General health perception and pain subscales are significantly higher in women (p<0.05). Conclusion: It is observed that patients experience problems after colectomy surgery and their quality of life is negatively affected.

Anahtar Kelimeler

• Colectomy
• colon cancer
• postoperative problems
• quality of life

Kaynakça

1. Centers for Disease Control and Prevention (CDC) Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. [Internet]. 2022. [cited 2022 Dec 8]. Available from: https://www.cdc.gov/cancer/colorectal/basic_info/what-is-colorectal-cancer.htm#:~:text=Colorectal%20cancer%20is%20a%20disease,the%20colon%20to%20the%20anus.
2. World Health Organisation WHO. Cancer. [Internet]. 2020. [cited 2022 Dec 8]. Available from: https://www.who.int/news-room/fact-sheets/detail/cancer#:~:text=colon%20and%20rectum%20(1.93%20million,stomach%20(1.09%20million%20cases.
3. Global Cancer Observatory (GLOBOCAN). Cancer Today. [Internet]. 2020. [cited 2022 Dec 8]. Available from: https://gco.iarc.fr/
4. American Cancer Society. Treating Colorectal Cancer. [Internet]. 2020. [cited 2022 Aug 15]. Available from: https://www.cancer.org/content/dam/CRC/PDF/Public/8607.00.pdf
5. Nishikimi K, Tate S, Matsuoka A, Otsuka S, Shozu M. Surgical Techniques and Outcomes of Colorectal Anastomosis after Left Hemicolectomy with Low Anterior Rectal Resection for Advanced Ovarian Cancer. Cancers (Basel). 2021;13(16):4248. doi: 10.3390/cancers13164248.
6. Hanna DN, Hawkins AT. Colorectal: Management of Postoperative Complications in Colorectal Surgery. Surg Clin North Am. 2021;101(5):717-729. doi: 10.1016/j.suc.2021.05.016.
7. Verkuijl SJ, Jonker JE, Trzpis M, Burgerhof JGM, Broens PMA, Furnée EJB. Functional outcomes of surgery for colon cancer: A systematic review and meta-analysis. Eur J Surg Oncol. 2021;47(5):960-969. doi: 10.1016/j.ejso.2020.11.136.
8. Harnsberger CR, Maykel JA, Alavi K. Postoperative Ileus. Clin colon rectal surg. 2019;32(3):166-170. doi: 10.1055/s-0038-1677003.

9. Waters PS, Cheung FP, Peacock O, Heriot AG, Warrier SK, O'Riordain DS, et al. Successful patient-oriented surgical outcomes in robotic vs laparoscopic right hemicolectomy for cancer - a systematic review. Colorectal Dis. 2020;22(5):488-499. doi: 10.1111/codi.14822.
10. Delaney CP, Chang E, Senagore AJ, Broder M. Clinical outcomes and resource utilization associated with laparoscopic and open colectomy using a large national database. Ann Surg. 2008;247(5):819-824. doi: 10.1097/SLA.0b013e31816d950e
11. Haanstra JF, de Vos Tot Nederveen Cappel WH, Gopie JP, Vecht J, Vanhoutvin SA, Cats A, et al. Quality of life after surgery for colon cancer in patients with Lynch syndrome: partial versus subtotal colectomy. Dis Colon Rectum. 2012;55(6):653-659. doi: 10.1097/DCR.0b013e31824f5392.
12. Greenblatt DY, Weber SM, O'Connor ES, LoConte NK, Liou JI, Smith MA. Readmission after colectomy for cancer predicts one-year mortality. Ann Surg. 2010;251(4):659-669. doi: 10.1097/SLA.0b013e3181d3d27c.
13. Aylaz G, Akyol C, Kocaay AF, Gökmen D, Yavuzarslan AB, Erkek AB, et al. Quality of life after colorectal surgery: A prospective study of patients compared with their spouses. World J Gastrointest Surg. 2021;13(9):1050-1062. doi: 10.4240/wjgs.v13.i9.1050.
14. Niu SF, Cheng SY, Chin CH. Quality of Life and Severity of Symptom Differences Between Post Open Colectomy and Laparoscopic Colectomy in Colorectal Cancer Patients. Cancer Nurs. 2021;44(4):E221-E228. doi: 10.1097/NCC.0000000000000793.
15. Graça Pereira M, Figueiredo AP, Fincham FD. Anxiety, depression, traumatic stress and quality of life in colorectal cancer after different treatments: A study with Portuguese patients and their partners. Eur J Oncol Nurs. 2012;16(3):227-232. doi: 10.1016/j.ejon.2011.06.006.
16. Ihnát P, Martínek L, Mitták M, Vávra P, Ihnát Rudinská L, Zonča P. Quality of life after laparoscopic and open resection of colorectal cancer. Dig. Surg. 2014;31(3):161–168. doi: 10.1159/000363415.
17. Cui M, Liu S. Meta-analysis of the effect of laparoscopic surgery and open surgery on long-term quality of life in patients with colorectal cancer. Medicine (Baltimore). 2023;102(36):e34922. doi: 10.1097/MD.0000000000034922.
18. Koçyiğit H, Aydemir Ö, Ölmez N, Memiş AK. SF-36’nın Türkçe için güvenilirliği ve geçerliliği. İlaç ve Tedavi Dergisi. 1999;12:102- 6.
19. Hasbahceci M, İdiz UO, Cengiz MB, Cipe G, Memmi N, Ümit Malya F, et al.. Risk factors for readmission following colorectal cancer surgery. Acta Oncol Tur. 2017; 50(1): 36-42.
20. Świątkowski F, Górnicki T, Bułdyś K, Chabowski M. The Quality of Life of Patients with Surgically Treated Colorectal Cancer: A Narrative Review. J Clin Med. 2022;11(20):6211. Published 2022 Oct 21. doi: 10.3390/jcm11206211.
21. Karaveli S, Özbayır T, Karacabay K. Kolorektal kanser ameliyatı geçiren hastaların ameliyat öncesi ve ameliyat sonrası dönemde yaşadıkları deneyimlerin incelenmesi. Anadolu Hemşire Sağlık Bilim Derg. 2014; 17(2): 90-96.
22. Nair CK, George PS. Rethnamma KS, Bhargavan R, Abdul Rahman S, et al. Factors Affecting Health Related Quality of Life of Rectal Cancer Patients Undergoing Surgery. Indian J Surg Oncol. 2017; 5,:266–273. doi: 10.1007/s13193-014-0346-z.
23. Bahayi K, Attaallah W, Yardımcı S, Bulut H, Özten E. Depression, Anxiety, Sexual Dysfunction and Quality of Life in Patients with Ileostomy or Colostomy. Turk J Colorectal Dis. 2018;28:69-75.
24. van Zutphen M, Winkels RM, van Duijnhoven FJ, van Harten-Gerritsen SA, Kok DE, van Duijvendijk P, et al. An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study. BMC Cancer. 2017;17:74. doi: 10.1186/s12885-017-3066-2.