Welcome to visit Zhongnan Medical Journal Press Series journal website!

Application of precision care model based on symptom management theory for patients after intersphincteric resection

Published on Aug. 31, 2024Total Views: 1091 timesTotal Downloads: 325 timesDownloadMobile

Author: YIN Yan 1 ZHANG Jie 2 HE Wenbin 3 DUAN Jing 3 LI Sisi 3 JIANG Congqing 3 XIE Xiaoyu 3 HU Xiaona 3 XIE Huixuan 3 LUO Man 3 SUN Wen 3

Affiliation: 1. Wound/Stoma Diagnosis and Treatment Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China 2. Retirement Office, Zhongnan Hospital of Wuhan University, Wuhan 430071, China 3. Department of Colorectal & Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China

Keywords: Rectal cancer Intersphincteric resection Anastomosis Precision care Symptom management theory

DOI: 10.12173/j.issn.1004-5511.202405003

Reference: Yin Y, Zhang J, He WB, Duan J, Li SS, Jiang CQ, Xie XY, Hu XN, Xie HX, Luo M, Sun W. Application of precision care model based on symptom management theory for patients after intersphincteric resection [J]. Yixue Xinzhi Zazhi, 2024, 34(8): 852-860. DOI: 10.12173/j.issn.1004-5511.202405003.[Article in Chinese]

  • Abstract
  • Full-text
  • References
Abstract

Objective  To explore the effects of precision care model for patients after intersphincteric resection based on symptom management theory.

Methods  Patients with intersphincteric resection in the colorectal and anal surgery department of Zhongnan Hospital of Wuhan University from June 2023 to March 2024 were prospectively selected by non-randomized concurrent controlled trail, and they were divided into the control group and the trial group according to the order of admission time. The control group received routine care, and the trial group received precision care model based on symptom management theory on the basis of the intervention in the control group. The anorectal function, anastomotic incidence and quality of life were compared between the two groups after intersphincteric resection.

Results  A total of 111 patients were enrolled in the study, with 56 in the trial group and 55 in the control group. The excellent rate of anorectal function in the trial group was significantly higher than that in the control group after surgery (69.64% vs. 34.55%, P<0.05). The trial group scored better than the control group in the quality of life function domains of body image, weight, anxiety, and libido, and in the symptom domains of urinary frequency, frequency of defecation, abdominal distension and so on(P < 0.05), but the difference between the two groups in the incidence of postoperative anastomotic complications was not statistically significant (3.57% vs. 10.91%, P>0.05).

Conclusion  The precise care model based on symptom management theory can effectively restore the anorectal function of patients and improve the quality of life of patients after intersphincteric resection.

Full-text
Please download the PDF version to read the full text: download
References

1.Wilkinson N. Management of rectal cancer[J]. Surg Clin North Am, 2020, 100(3): 615-628. DOI: 10.1016/j.suc.2020.02.014.

2.胡锦蕊, 赵红, 彭雨琪, 等. 直肠癌患者术后低位前切除综合征发生风险预测模型的系统评价[J]. 中国循证医学杂志, 2024, 24(3): 295-302. [Hu JR, Zhao H, Peng YQ, et al. Risk prediction models for the occurrence of low anterior resection syndrome in patients with rectal cancer after surgery: a systematic review[J]. Chinese Journal of Evidence-Based Medicine, 2024, 24(3): 295-302.] DOI: 10.7507/1672-2531.202306144.

3.Keller DS, Berho M, Perez RO, et al. The multidisciplinary management of rectal cancer[J]. Nat Rev Gastroenterol Hepatol, 2020, 17(7): 414-429. DOI: 10.1038/s41575-020-0275-y.

4.Shirouzu K, Murakami N, Akagi Y. Intersphincteric resection for very low rectal cancer: a review of the updated literature[J]. Ann Gastroenterol Surg, 2017, 1(1): 24-32. DOI: 10.1002/ags3.12003.

5.Toyoshima A, Nishizawa T, Sunami E, et al. Narrow pelvic inlet plane area and obesity as risk factors for anastomotic leakage after intersphincteric resection[J]. World J Gastrointest Surg, 2020, 12(10): 425-434. DOI: 10.4240/wjgs.v12.i10.425.

6.Martin ST, Heneghan HM, Winter DC. Systematic review of outcomes after intersphincteric resection for low rectal cancer[J]. Br J Surg, 2012, 99(5): 603-612. DOI: 10.1002/bjs.8677.

7.张斌, 卓光鑽, 赵玉涓, 等. 腹腔镜低位直肠癌经括约肌间切除术后吻合口漏的危险因素分析[J]. 中华普通外科杂志, 2020, 35(1): 8-12. [Zhang B, Zhuo GZ, Zhao YJ, et al. Risk factors for anastomotic leakage after laparoscopic intersphincteric resection for low-lying rectal cancer[J]. Chinese Journal of General Surgery, 2020, 35(1): 8-12.] DOI: 10.3760/cma.j.issn.1007-631X.2020.01.003.

8.张斌, 卓光鑽, 田雷, 等. 腹腔镜低位直肠癌经括约肌间切除术后吻合口狭窄危险因素分析[J]. 中华胃肠外科杂志, 2019, 22(8): 755-761. [Zhang B, Zhuo GZ, Tian L, et al. Risk factors of coloanal anastomotic stricture after laparoscopic intersphincteric resection for low rectal cancer[J]. Chinese Journal of Gastrointestinal Surgery, 2019, 22(8): 755-761.] DOI: 10.3760/cma.j.issn.1671?0274.2019.08.010.

9.Mathew A, Doorenbos AZ, Vincent C. Symptom management theory: analysis, evaluation, and implications for caring for adults with cancer[J]. ANS Adv Nurs Sci, 2021, 44(3): e93-e112. DOI: 10.1097/ANS. 0000000000000347.

10.Wong E, Bertin N, Hebrard M, et al. The Singapore national precision medicine strategy[J]. Nat Genet, 2023, 55(2): 178-186. DOI: 10.1038/s41588-022-01274-x.

11.中华医学会外科学分会结直肠外科学组. 低位直肠癌经括约肌间切除术中国专家共识(2023版)[J]. 中华胃肠外科杂志, 2023, 26(6): 536-547. [Chinese Society of Colorectal Surgery. Chinese expert consensus on intersphincteric resection for low rectal cancer (2023 edition)[J]. Chinese Journal of Gastrointestinal Surgery, 2023, 26(6): 536-547.] DOI: 10.3760/cma.j.cn441530-20230404-00101.

12.Yang W, Huang L, Chen P, et al. A controlled study on the efficacy and quality of life of laparoscopic intersphincteric resection (ISR) and extralevator abdominoperineal resection (ELAPE) in the treatment of extremely low rectal cancer[J]. Medicine (Baltimore), 2020, 99(22): e20245. DOI: 10.1097/MD.0000000000020245.

13.中华医学会外科学分会结直肠外科学组. 中国直肠癌手术吻合口漏诊断、预防及处理专家共识(2019 版) [J]. 中华胃肠外科杂志, 2019, 22(3): 201-206. [Chinese Society of Colorectal Surgery. Expert consensus on diagnosis, prevention and management of anastomotic leakage for rectal cancer in China (2019 Edition)[J]. Chinese Journal of Gastrointestinal Surgery, 2019, 22(3): 201-206.] DOI: 10.3760/cma.j.issn.1671?0274.2019.03.001.

14.徐忠法, 左文述, 刘奇. 现代肛肠肿瘤外科学[M]. 济南: 山东科学技术出版社, 1993. [Xu ZF, Zuo WS, Liu Q. Modern Anorectal Tumor Surgery[M]. Jinan: ShangDong Science &Technology Press, 1993.]

15.Kalkdijk-Dijkstra AJ, van der Heijden JAG, van Westreenen HL, et al. Pelvic floor rehabilitation to improve functional outcome and quality of life after surgery for rectal cancer: study protocol for a randomized controlled trial (FORCE trial)[J]. Trials, 2020, 21(1): 112. DOI: 10.1186/s13063-019-4043-7.

16.Lin JB, Zhang L, Wu DW, et al. Validation of the Chinese version of the EORTC QLQ-CR29 in patients with colorectal cancer[J]. World J Gastroenterol, 2017, 23(10): 1891-1898. DOI: 10.3748/wjg.v23.i10.1891.

17.潘莉娟, 王黎梅, 董卫红, 等. 低位直肠癌保肛术回肠造口还纳盆底肌锻炼肛门功能恢复探讨[J]. 浙江临床医学, 2016, 18(6): 1118-1119. [Pan LJ, Wang LM, Dong WH, et al. Discussion of recovery of anal function by reducing pelvic muscle through ileostomy after anal preservation for low rectal cancer[J]. Zhejiang Clinical Medical Journal, 2016, 18(6): 1118-1119.] https://d.wanfangdata.com.cn/periodical/zjlcyx201606058

18.罗莉, 吕真冰, 杨华, 等. 协同护理模式对低位直肠癌患者保肛术后肛门括约肌功能训练效果的影响[J]. 中华现代护理杂志, 2016, 22(17): 2404-2407. [Luo L, Lyu ZB, Yang H, et al. Influence of CCM on postoperative function training effect of anal sphincter in patients with anus preserving surgery for low rectal cancer[J]. Chinese Journal of Modern Nursing, 2016, 22(17): 2404-2407.] DOI: 10.3760/cma.j.issn.1674-2907.2016.17.009.

19.柏丹, 周冬兵, 范雨诗, 等. 基于计划行为理论的康复护理对直肠癌保肛术后患者肛门直肠动力学和生活质量的影响[J]. 结直肠肛门外科, 2023, 29(4): 401-407. [Bai D, Zhou DB, Fan YS, et al. Effect of rehabilitation nursing base on theory of planned behavior on anorectal dynamics and quality of life in rectal cancer patients after sphincter-preserving surgery for rectal cancer[J]. Journal of Colorectal & Anal Surgery, 2023, 29(4): 401-407.] DOI: 10.19668/j.cnki.issn1674-0491.2023.04.020.

20.韩加刚, 王振军. 低位直肠癌保肛手术方式选择[J]. 中国实用外科杂志, 2019, 39(7): 676-680. [Han JG, Wang ZJ. Selection of anal preservation surgery of low rectal cancer[J]. Chinese Journal of Practical Surgery, 2019, 39(7): 676-680.] DOI: 10.19538/j.cjps.issn1005-2208. 2019.07.08.

21.王娜, 刘洁, 李晓东, 等. 中国1990—2019年结直肠癌疾病负担分析[J]. 中国循证医学杂志, 2021, 21(5): 520-524. [Wang N, Liu J, Li XD, et al. An analysis of disease burden of colorectal cancer in China from 1990 to 2019[J]. Chinese Journal of Evidence-Based Medicine, 2021, 21(5): 520-524.] DOI: 10.7507/1672-2531. 202012006.

22.石维坤, 李昀昊, 邱小原, 等. 新辅助治疗模式下局部进展期直肠癌患者保肛术后生活质量的调查研究[J]. 中华胃肠外科杂志, 2022, 25(4): 348-356. [Shi WK, Li YH, Qiu XY, et al. Quality of life of patients with locally advanced rectal cancer after neoadjuvant therapy and sphincter-preserving surgery[J]. Chinese Journal of Gastrointestinal Surgery, 2022, 25(4): 348-356.] DOI: 10.3760/cma.j.cn441530-20210808-00315.

23.Aytaç E, Özer L, Baca B, et al. Optimizing the personalized care for the management of rectal cancer: a consensus statement[J]. Turk J Gastroenterol, 2022, 33(8): 627-663. DOI: 10.5152/tjg.2022.211103.

24.Ryoo SB. Low anterior resection syndrome[J]. Ann Gastroenterol Surg, 2023, 7(5): 719-724. DOI: 10.1002/ags3.12695.

25.Hamamoto H, Okuda J, Yamamoto M, et al. Preventing anastomotic leakage after laparoscopic intersphincteric resection without a diverting stoma: "pull-through/reborn"[J]. Asian J Endosc Surg, 2021, 14(2): 314-317. DOI: 10.1111/ases.12841.

26.孙佳男, 胡海燕, 殷欣, 等. 基于时机理论的直肠癌患者低位前切除综合征预防干预效果研究[J]. 中国护理管理, 2023, 23(12): 1761-1767. [Sun JN, Hu HY, Yin X, et al. Preventive effects of low anterior resection syndrome in rectal cancer patients based on the theory of timing it right[J]. Chinese Nursing Management, 2023, 23(12): 1761-1767.] DOI: 10.3969/j.issn.1672-1756. 2023.12.001.