Heits Nils, Bernsmeier Alexander, Reichert Benedikt, Hauser Charlotte, Hendricks Alexander, Seifert Dana, Richter Florian, Schafmayer Clemens, Ellrichmann Mark, Schniewind Bodo, Hampe Jochen, Becker Thomas, Egberts Jan-Hendrik
Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.
Interdisciplinary Endoscopy, Department of Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany.
J Thorac Dis. 2018 Jan;10(1):228-240. doi: 10.21037/jtd.2017.12.31.
Endoluminal vacuum therapy (EVT) has been successfully established with promising survival rates in the treatment of anastomotic leakages after esophagectomy. It is still unclear how this therapy affects health related quality of life (HRQOL).
HRQOL was prospectively assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) questionnaire. Assessment was carried out prior to surgery, after discharge, 6 months and 12 months after surgery. We compared HRQOL after EVT (n=23) to patients without anastomotic leakages as a control group (n=50). Investigated parameters included age, sex, and localization of anastomosis, number of EVT sessions, length of ICU and hospital stay, therapy failure, anastomotic stricture, tumour stage, neoadjuvant and adjuvant treatment, sepsis.
After esophagectomy HRQOL increased within 12 months. Compared to patients without leakages the EVT-group showed significantly better HRQOL-scores for pain, social and emotional functioning after discharge and 6 months after surgery. In the long-term follow up HRQOL was comparable between the groups. After EVT age, advanced tumour stage, tumour recurrence, anastomotic strictures, length of ICU and hospital stay and length of EVT had a significant influence on HRQOL.
EVT is a promising therapeutic option in leakages after esophagectomy. In the long-term, HRQOL of EVT-treated patients is comparable to patients, who did not suffer from postsurgical leakages.
腔内负压疗法（EVT）已成功应用于食管癌切除术后吻合口漏的治疗，其生存率令人满意。目前尚不清楚该疗法如何影响健康相关生活质量（HRQOL）。
采用欧洲癌症研究与治疗组织生活质量问卷C30（EORTC QLQ-C30）前瞻性评估HRQOL。评估在手术前、出院后、术后6个月和12个月进行。我们将接受EVT治疗的患者（n = 23）与无吻合口漏的患者作为对照组（n = 50）进行HRQOL比较。研究参数包括年龄、性别、吻合口位置、EVT治疗次数、ICU住院时间和住院时间、治疗失败、吻合口狭窄、肿瘤分期、新辅助和辅助治疗、败血症。
食管癌切除术后12个月内HRQOL有所提高。与无吻合口漏的患者相比，EVT组在出院后和术后6个月的疼痛、社会和情感功能方面的HRQOL评分明显更高。在长期随访中，两组之间的HRQOL相当。EVT治疗后，年龄、肿瘤晚期、肿瘤复发、吻合口狭窄、ICU住院时间和住院时间以及EVT持续时间对HRQOL有显著影响。
EVT是食管癌切除术后吻合口漏的一种有前景的治疗选择。从长期来看，接受EVT治疗的患者的HRQOL与未发生术后吻合口漏的患者相当。
