Liu Jie, Yang Kun, Chen Xin-Zu, Dai Bin, Zhang Bo, Chen Zhi-Xin, Chen Jia-Ping, Zhou Zong-Guang, Hu Jian-Kun
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Hepatogastroenterology. 2012 Oct;59(119):2207-12. doi: 10.5754/hge11830.
BACKGROUND/AIMS: This study investigated quality of life (QoL) of patients 6 months after surgery for early or advanced gastric cancer.
Between June, 2006 and December, 2009, 39 patients undergoing laparoscopic assisted distal gastrectomy (LADG) and 35 patients undergoing open distal gastrectomy (ODG) were enrolled. All the patients completed a validated questionnaire (EORTC QLQ-C30) and site specific module (QLQ-STO22) after surgery. Clinicopathological characteristics were compared and the patients' QoL were emphasized.
There were no significant differences between the two groups in age, comorbidities, curative degree, tumor stage, etc. In terms of QLQ-C30 items, significantly better role, cognitive, emotional and social functioning in the LADG group were identified as well as a significant lower incidence rate of constipation. Physical functioning, dyspnea, pain, fatigue, insomnia, diarrhea, financial difficulties and global health status, were not significantly different between the two groups. With respect to QLQ-STO22 items, LADG associated with lower incidence of reflux symptoms and better body image. However, there were no significant differences on symptoms of dysphagia, pain, eating restrictions, dry mouth, change of taste, anxiety and hair loss. QoL stratified by Billroth II reconstruction procedure gave similar results except for role functioning and body image, LADG had higher score compared with ODG.
Long-term follow-up results suggest that LADG might help improve the QoL in patients with gastric cancer. Well-designed large scale randomized controlled trials are needed.
背景/目的:本研究调查了早期或进展期胃癌患者术后6个月的生活质量(QoL)。
2006年6月至2009年12月期间,纳入39例行腹腔镜辅助远端胃切除术(LADG)的患者和35例行开放远端胃切除术(ODG)的患者。所有患者术后均完成一份经过验证的问卷(EORTC QLQ-C30)和特定部位模块(QLQ-STO22)。比较临床病理特征并强调患者的生活质量。
两组在年龄、合并症、治愈程度、肿瘤分期等方面无显著差异。就QLQ-C30项目而言,LADG组在角色、认知、情感和社会功能方面明显更好,便秘发生率也显著更低。两组在身体功能、呼吸困难、疼痛、疲劳、失眠、腹泻、经济困难和总体健康状况方面无显著差异。关于QLQ-STO22项目,LADG与反流症状发生率较低和身体形象较好相关。然而,在吞咽困难、疼痛、饮食限制、口干、味觉改变、焦虑和脱发症状方面无显著差异。除角色功能和身体形象外,按毕罗Ⅱ式重建手术分层的生活质量结果相似,LADG组得分高于ODG组。
长期随访结果表明,LADG可能有助于改善胃癌患者的生活质量。需要设计良好的大规模随机对照试验。