ヤマグチ　シゲキ   YAMAGUCHI Shigeki   山口　茂樹    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Quality of life after laparoscopic surgery for very low rectal cancer: A sub-analysis of the ultimate trial
掲載誌名	正式名：Colorectal disease 略　 称：Colorectal Dis ISSNコード：14631318/14628910
掲載区分	国外
巻・号・頁	27(10),pp.e70255
著者・共著者	HAMAMOTO Hiroki,TANAKA Keitaro,TSUKADA Yuichiro,WATANABE Jun,FUKUNAGA Yosuke,HIRANO Yasumitsu,SAKAMOTO Kazuhiro,YOSHIMITSU Masanori,HORIE Hisanaga,MATSUHASHI Nobuhisa,KURIU Yoshiaki,NAGAI Shuntaro,HAMADA Madoka,YOSHIOKA Shinichi,OHMURA Shinobu,HAYAMA Tamuro,OTSUKA Koki,INOUE Yusuke,UEDA Kazuki,TOIYAMA Yuji,MARUYAMA Satoshi,YAMAGUCHI Shigeki,SUZUKI Motoko,MISUMI Toshihiro,NAITOH Takeshi,WATANABE Masahiko,ITO Masaaki
発行年月	2025/10
概要	AIM:Laparoscopic low anterior resection is widely used for treating rectal cancer; however, postoperative complications frequently result in a marked deterioration in the patients' quality of life (QOL). This study aimed to investigate the trajectory of QOL recovery and identify the risk factors affecting QOL in patients undergoing laparoscopic surgery for very low rectal cancer.METHOD:This prospective, multi-institutional, single-arm, phase-II trial examined the outcomes of laparoscopic surgery in patients with very low rectal cancer (<5 cm from the anus). The Short Form 36 Health Survey questionnaire was used to assess QOL preoperatively and at 3 and 6 months and 1, 2 and 3 years postoperatively. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for impaired QOL.RESULTS:Overall, 259 patients were analysed, of whom 63% underwent intersphincteric resection. The physical component summary (PCS) score declined postoperatively but gradually recovered, whereas the mental component summary score showed sustained improvement. The role component summary (RCS) score significantly declined at 3 months but improved over time. Multivariate analysis identified stage III cancer as a risk factor for prolonged PCS decline (p = 0.0084) and Wexner score ≥9 at 1 year after surgery as a predictor of lower RCS score (p = 0.0116).CONCLUSION:QOL after laparoscopic surgery for low-lying rectal cancer is generally acceptable. Patients with stage III cancer experience prolonged physical challenges, whereas those with bowel dysfunction struggle with role/social domains of QOL. Targeted interventions should be implemented to address these issues.
DOI	10.1111/codi.70255
PMID	41054197