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吻合口并发症对食管癌切除术后健康相关生活质量的影响。

Impacts of anastomotic complications on the health-related quality of life after esophagectomy.

作者信息

Huang Qingyuan, Zhong Jiudi, Yang Tianzhen, Li Jinhui, Luo Kongjia, Zheng Yuzhen, Yang Hong, Fu Jianhua

机构信息

Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative innovation Center for Cancer Medicine, Guangzhou, P.R. China; Guangdong Esophageal Cancer Institute, Guangzhou, P.R. China.

出版信息

J Surg Oncol. 2015 Mar 15;111(4):365-70. doi: 10.1002/jso.23837. Epub 2014 Nov 21.

Abstract

BACKGROUD AND OBJECTIVES

Health-related quality of life (HRQL) is of great importance in cancer management. The aim was to identify factors that influence postoperative HRQL in esophageal carcinoma patients.

METHODS

A prospective cohort study was conducted to enroll 196 patients with esophageal carcinoma from November 2012 to June 2013. Sociademographic and clinicopathological parameters were recorded in detail. EORTC-QLQ C30 and ES18 were used to assess HRQL before surgery, at discharge, 1 and 6 months after discharge. Logistic regression models were used to identify factors independently influencing quality of life at 6 months after discharge.

RESULTS

HRQL dramatically decreased after esophagectomy, but restored within 6 months in the most scales. Multivariate logistic regression analysis showed that gender (P = 0.002) and anastomotic stricture (P = 0.001) were the independent predictors of poor global quality-of-life 6 months after discharge. Anastomotic stricture occurred in 22 patients (11.2%), and their performance in social function (P = 0.04), problems with eating (P = 0.006), choking when swallowing (P < 0.001) were significantly poorer at 6 months after discharge. There were not significant differences in global quality-of-life between patients with and without anastomotic leakage at three postoperative assessments.

CONCLUSIONS

Postoperative HRQL is restored within 6 months after discharge. Occurrence of anastomotic stricture significantly decreases HRQL after esophagectomy.

摘要

背景与目的

健康相关生活质量(HRQL)在癌症管理中至关重要。本研究旨在确定影响食管癌患者术后HRQL的因素。

方法

进行一项前瞻性队列研究,于2012年11月至2013年6月纳入196例食管癌患者。详细记录社会人口统计学和临床病理参数。采用欧洲癌症研究与治疗组织生活质量核心问卷(EORTC-QLQ C30)和食管癌特异模块(ES18)在术前、出院时、出院后1个月和6个月评估HRQL。采用逻辑回归模型确定出院后6个月独立影响生活质量的因素。

结果

食管切除术后HRQL显著下降,但在大多数量表中6个月内恢复。多因素逻辑回归分析显示,性别(P = 0.002)和吻合口狭窄(P = 0.001)是出院后6个月总体生活质量差的独立预测因素。22例(11.2%)患者发生吻合口狭窄,出院后6个月他们在社会功能(P = 0.04)、进食问题(P = 0.006)、吞咽时呛咳(P < 0.001)方面的表现明显较差。术后三次评估中,有和无吻合口漏的患者在总体生活质量方面无显著差异。

结论

术后HRQL在出院后6个月内恢复。吻合口狭窄的发生显著降低食管切除术后的HRQL。

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