title: [Investigation of quality of life in rectal cancer patients after anterior resection and expression of 5-hydroxytryptamine in rectal mucosa before and after operation].
abstract: OBJECTIVE
  To investigate the quality of life of rectal cancer patients after anterior resection and the role of 5-hydroxytryptamine(5-HT) in the pathogenesis of anterior resection syndrome (ARS).
  
  
  METHODS
  Between November 2012 and October 2014, 90 rectal cancer patients who underwent Dixon procedure in the Institute of Surgery Research, Daping Hospital, Third Military Medical University, and developed ARS postoperatively were enrolled in the study. By clinic interview and telephone follow-up, they were investigated according to the 4 questionnaires, including gastrointestinal quality of life index(GIQLI), Wexner constipation and incontinence score(WCS, WIS), and 36-item short form health survey(SF-36). Associated clinical data and above parameters were compared between postoperative 0-6 months and 7-24 months. Expression of 5-HT in rectal mucosa was determined by immunohistochemistry preoperatively and postoperatively.
  
  
  RESULTS
  The GIQLI, WCS and WIS were significantly improved in 7-24 months group compared with those in 0-6 months group(all P<0.05). Furthermore, the SF-36 test result also showed significant improvement in the terms of physical function, physical role, vitality, social function, emotional role and health changes spheres in 7-24 months group(P<0.05). 5-HT expression in rectal mucosa(upper anastomosis 3402.95±1876.24, lower anastomosis 3045.35±1373.59 of ARS patients was significantly down-regulated compared with the preoperative expression(rectal margin mucosa 7176.60±3927.61)(P<0.05).
  
  
  CONCLUSIONS
  Patients with ARS experience a significant trend toward recovery in their whole long-term quality of life. The down-regulation of 5-HT expression in rectal mucosa after surgery may be related with the pathogenesis of ARS.
authors.affiliation: Department of General Surgery, Institue of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing 400042, China. vdtong@163.com.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Liu
authors.forename: Yue
authors.initials: Y
authors.lastname: Tian
authors.forename: Weidong
authors.initials: W
authors.lastname: Tong
authors.forename: Hanyong
authors.initials: H
authors.lastname: Yang
authors.forename: Bin
authors.initials: B
authors.lastname: Huang
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Tao
authors.initials: T
authors.lastname: Fu
authors.forename: Chunxue
authors.initials: C
authors.lastname: Li
authors.forename: Fan
authors.initials: F
authors.lastname: Li
authors.forename: Anping
authors.initials: A
authors.lastname: Zhang
authors.forename: Baohua
authors.initials: B
authors.lastname: Liu
mesh_terms: D003248:Constipation; D006801:Humans; D007413:Intestinal Mucosa; D011446:Prospective Studies; D011788:Quality of Life; D012004:Rectal Neoplasms; D012701:Serotonin; D016896:Treatment Outcome
chemical_list: D012701:Serotonin