Lebensqualität nach radikaler Zystektomie – Übersicht und Analyse einer aktuellen Serie

Zusammenfassung

Fragestellung: Bisherige Studien zur Lebensqualität nach radikaler Zystektomie konnten keinen hinreichend aussagekräftigen Vorteil für eine Harnableitungsform verdeutlichen. Material und Methoden: 61 Patienten nach radikaler Zystektomie wurden zu ihrer Lebensqualität retrospektiv befragt (EORTC-QLQ-C30 und -BLM30). Die Daten wurden in Abhängigkeit vom Alter, dem Geschlecht, der Harnableitungsform und dem zeitlichen Abstand zur Therapie statistisch analysiert. Ergebnisse: 36 Patienten hatten inkontinente und 20 Patienten kontinente Harnableitungen. Jüngere Patienten (p = 0,001) und Patienten mit kontinenter Harnableitung (p = 0,03) waren statistisch signifikant häufiger mit finanziellen Problemen konfrontiert. Patienten mit einer kontinenten Harnableitung gaben zudem signifikant häufiger Probleme mit der sozialen Integration (p = 0,032) an. Zusätzlich bestanden signifikante Unterschiede bei der sozialen Integration (p = 0,03) und Emotionsfähigkeit (p = 0,008) bei der altersabhängigen Analyse. Patienten mit einer kontinenten Harnableitung gaben signifikant häufiger meteoristische Beschwerden an (p = 0,007). Schlussfolgerung: Auch in dieser Studie konnte ein klarer Unterschied in Abhängigkeit von der Harnableitung nicht dokumentiert werden. Eine gute postoperative Lebensqualität ist offenbar auch bei einem fortgeschrittenen Alter möglich. 

Abstract

Objective: Published evidence does not support a clear advantage in quality of life for continent versus incontinent urinary diversion or vice versa. Patients and Methods: We retrospectively assessed 61 patients after radical cystectomy with the EORTC-QLQ-C30 and -BLM30 instruments. Analysis was performed in dependence of age, sex, technique of urinary diversion and time-course of therapy. Results: 36 patients had an incontinent and 20 patients a continent urinary diversion. Younger patients (p = 0.001) and those with a continent urinary diversion (p = 0.03) were found to have a statistically significant higher incidence of financial problems. Also patients with continent urinary diversion had significantly (p = 0.032) more problems in social integration. Furthermore, there were significant differences in social integration (p = 0.03) and emotional ability (p = 0.008) in the age-dependent analysis. Patients with a continent diversion had significantly more meteoristic problems (p = 0.007). Conclusion: This study also could not demonstrate any clear differences in dependence on the technique of urinary diversion. A good postoperative quality of life seems possible independent of age.

Harnblasenkarzinom - Zystektomie - Harnableitung - Lebensqualität

bladder cancer - cystectomy - urinary diversion - quality of life

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