Gockel I, Pietzka S, Junginger Th
Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes-Gutenberg-Universität Mainz.
Chirurg. 2005 Mar;76(3):250-7. doi: 10.1007/s00104-004-0950-5.
Recently, quality of life has become a main objective in surgical therapy. Apart from the oncological consequences, the quality of results after gastric carcinoma resection are mainly determined by social and psychological aspects of life, early postoperative complications, and long-term nutritive/functional parameters. Of 338 patients who underwent gastric resection for adenocarcinoma of the stomach, quality of life was assessed in 73 recurrence-free patients by means of the Gastrointestinal Life Quality Index (GLQI). The median age was 71.9 years, and surgery had been carried out at least 1 year prior to the investigation (median follow-up 4.5 years). Patients with subtotal gastric resection displayed significantly higher GLQI scores (120 [97-138] points) than patients with gastrectomy (116 [70-139] points;p=0.047). Among partial parameters of the life quality index, physical functions were significantly better after subtotal resection (p=0.040), while the emotional status (p=0.147) and social activities (p=0.337) did not differ between the two groups. Abdominal symptoms (p=0.081) and the nutritional function (p=0.228) were insignificantly different. The number of meals (4 vs. 5 meals per day) and the loss of weight since surgery (5 vs. 10 kg) were less after subtotal resection than after gastrectomy. However, the latter parameter did not reach statistical significance.
最近,生活质量已成为外科治疗的主要目标。除了肿瘤学后果外,胃癌切除术后的结果质量主要由生活的社会和心理方面、术后早期并发症以及长期营养/功能参数决定。在338例行胃癌切除术的患者中,通过胃肠道生活质量指数(GLQI)对73例无复发患者的生活质量进行了评估。中位年龄为71.9岁,手术至少在调查前1年进行(中位随访4.5年)。胃次全切除患者的GLQI评分(120[97 - 138]分)显著高于胃全切患者(116[70 - 139]分;p = 0.047)。在生活质量指数的部分参数中,次全切除术后身体功能明显更好(p = 0.040),而两组之间的情绪状态(p = 0.147)和社交活动(p = 0.337)没有差异。腹部症状(p = 0.081)和营养功能(p = 0.228)差异不显著。次全切除术后每天的进餐次数(4次对5次)和术后体重减轻(5kg对10kg)均少于胃全切术后。然而,后一参数未达到统计学意义。