Department of Cardiothoracic Surgery, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.
Eur J Cardiothorac Surg. 2011 Jan;39(1):109-14. doi: 10.1016/j.ejcts.2010.04.032. Epub 2010 Jun 9.
For patients undergoing oncologic surgery, the quality of life (QoL) is generally accepted as an important outcome parameter in addition to long-term survival, mortality and complication rates. This study focussed on the QoL in patients after oesophagectomy for cancer, comparing the method of reconstruction (narrow gastric tube vs whole stomach).
In a prospective randomised single-centre study from 2007 to 2008, 104 patients underwent oesophagectomy for cancer. To assess the QoL, a questionnaire in reference to the EORTC-QLQ-C30 and the QLQ-OES24 was administered at 3 weeks, 6 months and 1 year after surgery. Clinical data were collected prospectively, and follow-up was performed regularly.
There were no significant differences between the narrow gastric tube group (NGT group, n=52) and the whole-stomach group (WS group, n=52) with regard to patient and cancer characteristics, operative procedure, postoperative intensive care unit (ICU) hospitalisation, and overall survival at 1 year. Regarding the postoperative complication, there were more cases of postoperative reflux oesophagitis and impairment of pulmonary function in the WS group (P<0.05). Regarding the QoL investigation, the scores of QoL dropped for all patients at 3 weeks after surgery. Slowly, recovery was found at both 6 months and 1 year in both groups. Patients in the NGT group reported significantly (P<0.05) better scores of QoL at both 6 months and 1 year.
Patients who underwent gastric tube reconstruction develop less postoperative digestive tract complications, and have a quicker recovery and a better QoL during the follow-up period. Further investigation and data collection will allow the assessment of this procedure beyond 1 year after operation.
对于接受肿瘤外科手术的患者，生活质量（QoL）通常被认为是除长期生存、死亡率和并发症发生率之外的一个重要的预后参数。本研究聚焦于癌症患者接受食管切除术后的生活质量，比较了两种重建方法（胃管重建与全胃重建）。
在 2007 年至 2008 年进行的一项前瞻性随机单中心研究中，104 例患者因癌症接受了食管切除术。为了评估生活质量，在术后 3 周、6 个月和 1 年使用 EORTC-QLQ-C30 和 QLQ-OES24 问卷进行评估。前瞻性收集临床数据，并定期进行随访。
在患者和癌症特征、手术程序、术后重症监护病房（ICU）住院时间以及 1 年总体生存率方面，窄胃管组（NGT 组，n=52）与全胃组（WS 组，n=52）之间没有显著差异。在术后并发症方面，WS 组的术后反流性食管炎和肺功能损害的发生率更高（P<0.05）。在生活质量调查方面，所有患者在术后 3 周时的生活质量评分均下降。在 6 个月和 1 年时，两组患者的生活质量均有所恢复。NGT 组患者在 6 个月和 1 年时的生活质量评分均显著更高（P<0.05）。
接受胃管重建的患者术后发生消化道并发症较少，在随访期间恢复较快，生活质量较高。进一步的研究和数据收集将允许评估该手术在术后 1 年以上的效果。
