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Articole originale Jurnalul de Chirurgie, Iaşi, 2011, Vol. 7, Nr. 2 [ISSN 1584 – 9341] 3. Berguer R. Current methods of vertebral artery revascularization. In Caplan L, Shifrin E, Nicolaides A, et al. eds. Cerebrovascular Ischemia: Investigation and Management. London-Los Angeles-Nicosia, Med Orion. 1996; p. 563-575. 4. Habozid B. Vertebral artery reconstruction : results in 106 pacients. Ann Vasc Surg.1991; 5: 121-124. 5. Imparato AM. Vertebral arterial reconstruction : a nineteen year experience. J Vasc Surg. 1985; 2: 626-633. 6. Kieffer E, Koskas F, Bahnini A, et al. Long term results after reconstruction of the cervical vertebral artery. In Caplan L, Shifrin E, Nicolaides A, et al. eds. Cerebrovascular Ischemia: Investigation and Management. London/Los Angeles/Nicosia, Med-Orion; 1996; p. 617-625. 7. Berguer R, Flynn L.M., Kline R.A., Caplan L. Surgical reconstruction of the extracranial vertebral artery: management and outcome. J. Vasc. Surg. 2000; 31: 9-18. 8. Berguer R, Feldman AJ. Surgical reconstruction of the vertebral artery. Surgery 1983; 93: 670- 675. 9. Cate WR, Scott HW. Cerebral ischemia of central origin: relief by subclavian-vertebral artery thromboendarterectomy. Surgery. 1959; 45: 19-31. 10. Caplan LR, Shifrin EG. Natural history of vertebrobasilar arterial disease. In Caplan L, Shifrin E, Nicolaides A, et al. eds. Cerebrovascular Ischemia : Investigation and Management. London/Los Angeles/Nicosia, Med Orion; 1996; p. 549-561. 177
Articole originale Jurnalul de Chirurgie, Iaşi, 2011, Vol. 7, Nr. 2 [ISSN 1584 – 9341] STOMIILE LA PACIENŢII CU CANCER DE COLON NEMETASTATIC. STUDIU PROSPECTIV ASUPRA CALITĂŢII VIEŢII Paula Popa 1,2 , C. Pleşa 2 , C.N. Neacşu 2 , D. Vintilă 2 , T. Ţăranu 2 , Liliana Forţu 2 , Şt. O. Georgescu 2 1. Doctorand Universitatea de Medicină şi Farmacie „Gr. T. Popa” Iaşi 2. Clinica II Chirurgie, Spitalul Universitar „Sf. Spiridon” Iaşi Universitatea de Medicină şi Farmacie „Gr. T. Popa” Iaşi THE OSTOMIES IN PATIENTS WITH NONMETASTATIC COLON CANCER. A QUALITY OF LIFE PROSPECTIVE STUDY (Abstract). Background. Colorectal cancer has a high incidence and 20% from these cases are admitted with complications. Unfortunately, these complications constrain frequently the surgeon to making a stoma. Material and method. During three years, between 2008 and 2010, we performed a prospective cohort study on 43 consecutive patients with nonmetastatic colon cancer surgically stomized in two surgical departments from University Hospital „Sf. Spiridon” Iaşi, Romania. The documented nonmetastatic colon cancer prior to surgery was the main selection criteria. Preoperatively the subjects answered to the items of the EORTC QLQ-C30 version 3.0 questionnaire. The stomized patiens with nonmetastatic colon cancer remained in study. A new interview based on EORTC QLQ-C30 questionnaire after three months from the initial surgery represented the recruitment endpoint. There were 31 men (72.1%) and 12 women (27.9%) with mean age 64.8±9.34 years (range 47 to 85 years). The reconstructive surgery was performed in 12 patients. The quality of life (QoL) of these subjects was measured again after three months from the reconstructive procedure. We assessed the following independent variables: gender, age, comorbidities, time between hospital admission and surgical procedure, tumor site, surgical procedure, ostomy type and chemotherapy. Results. After three months from the ostomy we registered a significant increase in global health status (QL), physical functioning (PF), role functioning (RF), emotional functioning (EF) and cognitive functioning (CF). Only social functioning remained insignificantly changed. A comparison between the registered QL and functioning scales with the reference scores showed the significant lower levels of the QoL after ostomy, excepting the CF. The symptoms scale was significantly improved after surgery with no significant differences from the EORTC reference values. The unresectable tumors and the ileostomy were the main variables correlate with a decrease in QoL status. In our sample, the EF and SF were the most affected functions. The statistical analysis on the patients with reconstructive surgery showed a significant increase in QoL status and the compensation of the previous lower levels of the EF and SF. Conclusions. The ostomies save the life of the patients with nonmetastatic complicated colon cancer and lead to the symptoms remission, but some problems regarding the adaptation at this undesired condition remain outstanding. Especially the patient with fixed ostomies requires the help from a psychologist and stomatherapist. KEYWORDS: QUALITY OF LIFE, COLON CANCER, ILEOSTOMY, COLOSTOMY. Corespondenţă: Dr. Paula Popa, Spitalul Universitar „Sf. Spiridon” Iaşi, Clinica II Chirurgie, B-dul Independenţei nr. 1, Iaşi, România, 700111 * . INTRODUCERE Cancerul colorectal reprezintă a doua cauză de deces prin cancer în SUA şi Japonia [1], fiind de asemenea o patologie foarte frecventă şi în serviciile chirurgicale din România. * received date: 07.02.2011 accepted date: 14.04.2011 178
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