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胃上提食管切除术后的长期生活质量

Long-term quality of life after esophagectomy with gastric pull-up.

作者信息

Mantoan Silvia, Cavallin Francesco, Pinto Eleonora, Saadeh Luca M, Alfieri Rita, Cagol Matteo, Bellissimo Maria C, Castoro Carlo, Scarpa Marco

机构信息

Surgical Oncology Unit, Veneto Institute of Oncology IOV IRCCS, Padua, Italy.

出版信息

J Surg Oncol. 2018 Apr;117(5):970-976. doi: 10.1002/jso.24995. Epub 2018 Feb 6.

Abstract

BACKGROUND AND OBJECTIVES

Data on long-term health-related quality of life (HRQL) after esophagectomy for cancer show contradictory results. The aim was to analyze long-term HRQL at 3 or more years after esophagectomy.

METHODS

Survivors were identified among patients who had undergone esophagectomy during 2007-2013 using the local clinic database. Quality of life was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 and OG25 questionnaires. Specific aspects were selected a priori and compared with published scores from European healthy subjects (mean difference, MD).

RESULTS

Sixty-five long-term survivors (median follow-up 4 years) were identified. All functional scales and most symptom scales were clinically similar between EC long-term survivors and European healthy subjects. Survivors reported more problems concerning eating (MD 13.1, 95% C.I. 10.6-15.6) and reflux (MD 19.7, 95% C.I. 15.9-23.5). HQRL variation from discharge to long term was available in 27 participants who reported improvements in role functioning (MD 40.1, 95%C.I. 24.3-56.0) and dysphagia (MD -41.9, 95% C.I. -51.7 to 32.0).

CONCLUSIONS

Long-term HRQL after esophagectomy is similar between EC survivors and European healthy subjects, despite persisting reflux and eating problems. Further research may focus on improvements of postoperative alimentary habits.

摘要

背景与目的

关于食管癌切除术后长期健康相关生活质量(HRQL)的数据显示出相互矛盾的结果。本研究旨在分析食管癌切除术后3年及以上的长期HRQL。

方法

利用当地诊所数据库,在2007年至2013年期间接受食管癌切除术的患者中识别出幸存者。使用欧洲癌症研究与治疗组织QLQ-C30和OG25问卷评估生活质量。预先选择特定方面,并与欧洲健康受试者公布的分数进行比较(平均差异,MD)。

结果

确定了65名长期幸存者(中位随访4年)。食管癌长期幸存者与欧洲健康受试者在所有功能量表和大多数症状量表上临床相似。幸存者报告在进食(MD 13.1,95%置信区间10.6 - 15.6)和反流(MD 19.7,95%置信区间15.9 - 23.5)方面存在更多问题。27名参与者提供了从出院到长期的HRQL变化情况,他们报告在角色功能(MD 40.1,95%置信区间24.3 - 56.0)和吞咽困难(MD -41.9,95%置信区间 -51.7至32.0)方面有所改善。

结论

尽管存在持续的反流和进食问题,但食管癌切除术后的长期HRQL在食管癌幸存者与欧洲健康受试者之间相似。进一步的研究可能聚焦于改善术后饮食习惯。

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