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Quality of life after laparoscopic vs open sphincter-preserving resection for rectal cancer

World Journal of Gastroenterology 2013年第29期19卷 4764-4773页

作者： Simon Siu-Man Ng Wing-Wa Leung cherry yee-ni wong Sophie Sok-Fei Hon Tony Wing-Chung Mak Dennis KwokYu Ngo Janet Fung-yee Lee Division for Colorectal Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital

AIM: To compare quality of life (QoL) outcomes in Chinese patients after curative laparoscopic vs open surgery for rectal cancer. METHODS: Eligible Chinese patients with rectal cancer undergoing curative laparoscopic or open sphincterpreserving resection between July 2006 and July 2008 were enrolled in this prospective study. The QoL outcomes were assessed longitudinally using the validated Chinese versions of the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQCR38 questionnaires before surgery and at 4, 8, and 12 mo after surgery. The QoL scores at the different time points were compared between the laparoscopic and open groups. A higher score on a functional scale indicated better functioning, whereas a higher score on a symptom scale indicated a higher degree of ***: Seventy-four patients (49 laparoscopic and 25 open) were enrolled. The two groups of patients were comparable in terms of sociodemographic data, types of surgery, tumor staging, and baseline mean QoL scores. There was no significant decrease from baseline in global QoL for the laparoscopic group at different time points, whereas the global QoL was worse compared to baseline beginning at 4 mo but returned to baseline by 12 mo for the open group (P = 0.019, Friedman test). Compared to the open group, the laparoscopic group had significantly better physical (89.9±1.4 vs 79.2±3.7, P = 0.016), role (85.0±3.4 vs 63.3±6.9, P = 0.005), and cognitive (73.5±3.4 vs 50.7±6.2, P = 0.002) functioning at 8 mo, fewer micturition problems at 4-8 mo (4 mo: 32.3±4.7 vs 54.7±7.1, P = 0.011; 8 mo: 22.8±4.0 vs 40.7±6.9, P = 0.020), and fewer male sexual problems from 8 mo onward (20.0±8.5 vs 76.7±14.5, P = 0.013). At 12 mo after surgery, no significant differences were observed in any functional or symptom scale between the two groups, with the exception of male sexual problems, which remained worse in the open group (29.2±11.3 vs 80.0±9.7, P = 0.026). CONCLUSION: Laparoscopic sphin

关键词： Quality of life Rectal cancer Laparoscopic surgery Sphincter-preserving surgery European Organization for Research and Treatment of Cancer QLQ-C30 European Organization for Research and Treatment of Cancer QLQ-CR38

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Crohn's disease genotypes of patients in remission vs relapses after infliximab discontinuation

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World Journal of Gastroenterology 2012年第36期18卷 5058-5064页

作者： Cathy Lu Alistair Waugh Robert J Bailey Raeleen cherry Levinus A Dieleman Leah Gramlich Kata Matic Mario Millan Karen I Kroeker Daniel Sadowski Christopher W Teshima Dennis Todoruk Clarence wong Karen wong Richard N Fedorak Division of Gastroenterology Zeidler Ledcor CenterUniversity of AlbertaEdmontonAB T6G 2X8Canada Division of Gastroenterology Royal Alexandra HospitalEdmontonAB T5H 3V9Canada Division of Gastroenterology Grey Nuns HospitalEdmontonAB T6L 5X8Canada Division of Gastroenterology Misericordia HospitalEdmontonAB T5R 4H5Canada

AIM:To investigate genetic differences between Crohn's disease(CD) patients with a sustained remission vs relapsers after discontinuing infliximab while in corticosteroid-free ***:Forty-eight CD patients received infliximab and were in full corticosteroid-free clinical remission but then discontinued infliximab for reasons other than a loss of response,were identified by review of an electronic database and ***-associated remission was defined as corticosteroid-free plus normalization of clinical disease activity [CD activity index(CDAI) nically defined as a physician visit for symptoms of disease activity(CDAI > 220) and a therapeutic intervention with CD medication(s),or a hospitalization with complications related to active *** analyses were performed on samples from 14 patients(n = 6 who had a sustained long term remission after stopping infliximab,n = 8 who rapidly relapsed after stopping infliximab).Nucleotide-binding oligomerization domain 2(NOD2)/caspase activation recruitment domain 15(CARD15) polymorphisms(R702W,G908R and L1007fs) and the inflammatory bowel disease 5(IBD5) polymorphisms(IGR2060a1 and IGR3081a1) were analyzed in each ***:Five single nucleotide polymorphisms of IBD5 and NOD2/CARD15 genes were successfully analyzed for all 14 *** was no significant increase in frequency of the NOD2/CARD15 polymorphisms(R702W,G908R and L1007fs) and the IBD5 polymorphisms(IGR2060a1 and IGR3081a1) in either group of patients;those whose disease relapsed rapidly or those who remained in sustained long term remission following the discontinuation of *** a third of patients in full clinical remission who stopped infliximab for reasons other than loss of response remained in sustained clinical remission,while two-thirds relapsed *** was a marked difference in the

关键词：基因型单抗患者复发基因多态性房产管理信息系统糖皮质激素临床疾病

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Acupuncture transcutaneous electrical nerve stimulation reduces discomfort associated with barostat-induced rectal distension:A randomized-controlled study

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World Journal of Gastroenterology 2013年第3期19卷 381-388页

作者： Wing-Wa Leung Alice YM Jones Simon SM Ng cherry YN wong Janet FY Lee Department of Rehabilitation Sciences The Hong Kong Polytechnic UniversityHung HomHong Kong 999077China Faculty of Health Sciences The University of SydneySydneyNSW 2006Australia Division of Colorectal Surgery Department of SurgeryThe Chinese University of Hong KongPrince of Wales HospitalShatinHong Kong 999077China

AIM:To explore the effectiveness of acupuncture transcutaneous electrical nerve stimulation(Acu-TENS), a non-invasive modality in reduction of rectal discomfort during barostat-induced rectal distension. METHODS:Forty healthy subjects were randomized to receive 45 min of either Acu-TENS or placebo-TENS(no electrical output)over acupuncture points Hegu(largeintestine 4),Neiguan(pericardium 6)and Zusanli(stomach 36).A balloon catheter attached to a dual-drive barostat machine was then inserted into the subjects'rectum.A step-wise(4 mmHg)increase in balloon pressure was induced until maximal tolerable or 48 *** analogue scale and a 5-point subjective discomfort scale(no perception,first per-ception of distension,urge to defecate,discomfort/ pain and extreme pain)were used to assess rectal discomfort at each distension *** beta-endorphin levels were measured before,immediately after intervention,at 24 mmHg and at maximal toler- able distension pressure. RESULTS:There was no difference in the demographic data and baseline plasma beta-endorphin levels between the two *** threshold levels were higher in the Acu-TENS group when compared to the placebo group,but the difference reached statistical significance only at the sensations"urge to defecate"and"pain".The distension pressures recorded at the"urge to defecate"sensation for the Acu-TENS and placebo-TENS groups were 28.0±4.5 mmHg and 24.6±5.7 mmHg,respectively(P=0.043);and the pressures recorded for the"pain"sensation for these two groups were 36.0±4.2 mmHg and 30.5± 4.3 mmHg respectively(P=0.002).Compared to the placebo group,a higher number of participants in the Acu-TENS group tolerated higher distension pressures (>40 mmHg)(65%in Acu-TENS vs 25%in placebo, P=0.02).The plasma beta-endorphin levels of the Acu-TENS group were significantly higher than that of the placebo group at barostat inflation pressure of 24 mmHg(1.31±0.40 ng/mL vs 1.04±0.43 ng/mL,P= 0.044)and at maximal inflation p

关键词： Colonoscopy Rectal discomfort Transcu-taneous electrical nerve stimulation Acupuncture Visceral pain

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