Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15 Col. Sección XVI, Tlalpan, 14000, Mexico, D.F.
J Gastrointest Surg. 2012 Jul;16(7):1341-6. doi: 10.1007/s11605-012-1898-2. Epub 2012 May 1.
Few studies compare the direct impact of pancreatoduodenectomy (PD) on the patient's quality of life (QOL). The effect of PD in QOL, comparing the preoperative vs. postoperative status, was analyzed.
A prospective single-center study was performed. PD patients in a 2-year period were included. A general QOL instrument was applied preoperative, 1, 3, 6, and 12 months after surgery and compared with national norms.
Thirty-seven patients were recruited. Twenty of 37 were female. Ampullary carcinoma 14/37, ductal adenocarcinoma in 9/37, and other malignant neoplasms 14/37 were diagnosed. Mortality was absent; 48.6% had complications, 13.5 % required reoperation. Three (median) and 4 (mode) questionnaires were answered per individual. 85 % answered the last questionnaire. 4/37 had cancer related death before a year. Median follow-up was 29 (3-72) months. QOL diminished a month after surgery, physical function (67 vs 40, p<0.0001) and emotional role (37 vs 17, p<0.032) did so significantly. Three months after surgery QOL improved yet not significantly. Six and 12 months postoperatively, physical role (9 vs 49, p=0.001), physical pain (51 vs 71, p=0.01), social function (52 vs 63, p=0.014), vitality (54 vs 64, p=0.018), and emotional role (41 vs 69, p=0.006) improved significantly.
PD has a favorable impact in quality of life as demonstrated by the improvement of most parameters assessed in the postoperative period.
很少有研究比较胰十二指肠切除术 (PD) 对患者生活质量 (QOL) 的直接影响。分析了 PD 对 QOL 的影响，比较了术前与术后的状态。
进行了一项前瞻性单中心研究。纳入了在 2 年内接受 PD 的患者。术前、术后 1、3、6 和 12 个月应用一般 QOL 量表，并与全国正常值进行比较。
共招募了 37 名患者。37 名患者中有 20 名女性。诊断为壶腹癌 14/37 例，胆管腺癌 9/37 例，其他恶性肿瘤 14/37 例。无死亡病例；48.6%发生并发症，13.5%需要再次手术。每位患者回答了 3 个（中位数）和 4 个（众数）问卷。85%回答了最后一个问卷。在一年内有 4/37 例癌症相关死亡。中位随访时间为 29（3-72）个月。术后 1 个月 QOL 下降，身体功能（67 比 40，p<0.0001）和情绪角色（37 比 17，p<0.032）明显下降。术后 3 个月 QOL 有所改善，但无统计学意义。术后 6 和 12 个月，身体角色（9 比 49，p=0.001）、身体疼痛（51 比 71，p=0.01）、社会功能（52 比 63，p=0.014）、活力（54 比 64，p=0.018）和情绪角色（41 比 69，p=0.006）明显改善。
PD 对生活质量有积极影响，术后评估的大多数参数均有所改善。
