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◆要旨：【目的】経肛門的標本摘出（TASE）による完全腹腔鏡下S状結腸切除術後の，包括的QOLと排便機能を後ろ向きに評価する．【方法】SF-36，Wexner's score，排便回数を用い，TASE群 32例を腹腔鏡補助下群（LAC群） 31例と比較した．【成績】SF-36では，「活力」「社会生活機能」「日常役割機能（精神）」「心の健康」において，術後2週間目から2か月目の間でTASEが優れていた．Wexner's scoreは両群間に有意差を認めなかった．1日最大排便回数は，術後3か月目にTASE群が有意に少なく（TASE vs. LAC, 中央値：3.0 vs. 4.0, P＝0.045），その後は両群間に有意差を認めなかった．【結論】Body mass indexが低値，小さな腫瘍径，進行度が比較的早期といった対象において，TASE術後のQOLは良好で排便機能に与える影響も軽度であった．
【Purpose】 This retrospective study was designed to assess quality of life（QOL） and anorectal functional results after totally laparoscopic sigmoidectomy with transanal specimen extraction（TASE）. 【Methods】 Preoperative and postoperative QOL and anorectal function were evaluated in consecutive patients who underwent laparoscopic surgery for sigmoid or rectosigmoid colon cancer, based on SF-36 and Wexner's incontinence score. We compared the results between 32 patients who underwent TASE and 31 patients with laparoscopic assisted colectomy（LAC）. 【Results】 There were significantly better scores in the TASE group in vitality at 2weeks after surgery（TASE vs. LAC: 56.3 vs. 48.2; P＝0.012）, social functioning at 1month（57.0 vs. 44.1; P＝0.007）, role emotional at 2weeks（51.9 vs. 35.3; P＝0.040）, and mental health at 2weeks and 2months（54.5 vs. 45.1; P＝0.049 and 55.8 vs. 49.1; P＝0.010 respectively）. The median Wexner's score at 6 months were comparable between the 2 groups（TASE vs. LAC: 1.0 vs. 1.5）. Median maximam number of bowel movement per day were significantly lower in the TASE group at 3months（3.0 vs. 4.0; P＝0.045）. There were no significant differences between the 2 groups at 6 months（3.0 vs. 3.5; P＝0.263）. 【Conclusion】 Totally laparoscopic sigmoidectomy with TASE was associated with good postoperative QOL and minimal influence on anorectal function in patients with low body mass index, small tumor, and early pathological stage.
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