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Advisor(s)
Abstract(s)
O cancro do reto apresenta uma elevada incidência a nível mundial, com maior preponderância em países desenvolvidos. Para além disso, apresenta também uma elevada mortalidade, o que levou à necessidade de desenvolver abordagens clínicas e cirúrgicas que permitam maior sobrevida e qualidade de vida para doentes que padeçam desta patologia. O esforço resultante culminou no desenvolvimento da resseção anterior baixa, que, atualmente, é a cirurgia padrão para tratamento deste tipo de cancro.
A resseção anterior baixa, apesar de melhorar a sobrevida a 5 anos, numa elevada percentagem de doentes, está associada à síndrome de resseção anterior baixa, que se manifesta por uma disfunção intestinal severa e que pode ter impacto muito significativo na qualidade de vida do doente.
Diversas foram as escalas empregues pelos clínicos na avaliação da síndrome de resseção anterior baixa, no entanto, todas revelaram apresentar falhas. Algumas das escalas utilizadas não eram validadas, outras avaliavam a incontinência fecal (um dos principais sintomas desta síndrome), porém não avaliavam os restantes sintomas, e outras ainda avaliavam todos estes elementos mas revelaram ser demasiado extensas e/ou complexas, tornando difícil a sua utilização na prática clínica.
Em 2012, de modo a resolver este problema foi criada a escala LARS. Esta escala conjuga várias características que a tornam um dos melhores instrumentos na investigação da síndrome de resseção anterior baixa, uma vez que, permite avaliar todos os seus sintomas e estimar o seu impacto na qualidade de vida. Além disto, é um instrumento sucinto, simples e de rápida aplicação e análise na prática clínica. Após a sua criação, esta escala recebeu validação internacional, tendo ainda sido traduzida e validada para diversas línguas e populações. Esta escala veio ainda possibilitar uma maior uniformização de dados e a comparação de resultados entre diferentes estudos que investigam este tipo de patologia.
The cancer of the rectum exhibits high incidence worldwide, with greater predominance in developed countries. Furthermore, it also presents a high mortality, which led to the necessity of developing clinical and surgical approaches that permit greater survival and quality of life for patients suffering from this pathology. The resulting effort culminated in the development of the low anterior resection, which, nowadays, is the standard surgery for treatment of this type of cancer. Low anterior resection, despite improving survival at 5 years, in a high percentage of patients, is associated with low anterior resection syndrome, that manifests itself by severe bowel dysfunction and that can have a very significant impact on the patient's quality of life. Several scales were employed by clinicians in evaluating low anterior resection syndrome, however, all of them have showed to have flaws. Some of the scales used were not validated, others evaluated fecal incontinence (one of the main symptoms of this syndrome), but did not evaluate the remaining symptoms, and others evaluated all these elements, however, they were too extensive and/or complex, making them difficult to use in clinical practice. In 2012, in order to solve this problem, the LARS scale was created. This scale combines several features that make it one of the best instruments in the investigation of low anterior resection syndrome, as it allows the evaluation of all its symptoms and the estimation of its impact on the quality of life. Beyond this it is an instrument that is simple, concise and of rapid application and analysis in the clinical practice. After its creation, this scale received international validation and it has been translated and validated in several languages and populations. This scale also allowed a greater standardization of data and the comparison of results among different studies investigating this type of pathology.
The cancer of the rectum exhibits high incidence worldwide, with greater predominance in developed countries. Furthermore, it also presents a high mortality, which led to the necessity of developing clinical and surgical approaches that permit greater survival and quality of life for patients suffering from this pathology. The resulting effort culminated in the development of the low anterior resection, which, nowadays, is the standard surgery for treatment of this type of cancer. Low anterior resection, despite improving survival at 5 years, in a high percentage of patients, is associated with low anterior resection syndrome, that manifests itself by severe bowel dysfunction and that can have a very significant impact on the patient's quality of life. Several scales were employed by clinicians in evaluating low anterior resection syndrome, however, all of them have showed to have flaws. Some of the scales used were not validated, others evaluated fecal incontinence (one of the main symptoms of this syndrome), but did not evaluate the remaining symptoms, and others evaluated all these elements, however, they were too extensive and/or complex, making them difficult to use in clinical practice. In 2012, in order to solve this problem, the LARS scale was created. This scale combines several features that make it one of the best instruments in the investigation of low anterior resection syndrome, as it allows the evaluation of all its symptoms and the estimation of its impact on the quality of life. Beyond this it is an instrument that is simple, concise and of rapid application and analysis in the clinical practice. After its creation, this scale received international validation and it has been translated and validated in several languages and populations. This scale also allowed a greater standardization of data and the comparison of results among different studies investigating this type of pathology.
Description
Keywords
Cancro do Reto Disfunção Intestinal Escala Lars Qualidade de Vida Síndrome de Resseção Anterior Baixa