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年龄不应成为腹腔镜手术的限制因素:一项关于腹腔镜子宫切除术术后生活质量的前瞻性多中心队列研究。

Age should not be a limiting factor in laparoscopic surgery: a prospective multicenter cohort study on quality of life after laparoscopic hysterectomy.

机构信息

Department of Gynecologic Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands,

Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

出版信息

Clin Interv Aging. 2018 Dec 13;13:2517-2526. doi: 10.2147/CIA.S172965. eCollection 2018.

Abstract

PURPOSE

A prospective, multicenter cohort study was performed on the implementation of laparoscopic hysterectomy (LH) in the Netherlands. The aim of this study was to evaluate the impact of LH on quality of life (QOL) with respect to age up to 6 months postoperatively.

PATIENTS AND METHODS

Women with an indication for LH, either for benign conditions or early-stage low-risk endometrial cancer were included. QOL was measured before and 6 weeks and 6 months after surgery, using the 36-item Short Form Health Survey. Mean QOL values were compared to an unselected, female, Dutch reference population. A longitudinal linear mixed model was applied to assess changes in QOL over time after LH and to determine if in patients ≥65 years of age QOL scores were different.

RESULTS

Data on 116 patients were available for analysis. The median age was 54 years at time of surgery (range 34-83) with an interquartile range of 43-65 years. Six months after LH, all QOL values were higher than before surgery and were equal to or higher than those of the reference population. Older women tend to score higher on QOL preoperatively, and these scores remain high postoperatively.

CONCLUSION

After LH, QOL improves. Older women report higher QOL values preoperatively and QOL is still high 6 months after the operation. Age does not confer a negative impact on QOL following LH and should not be the reason to refrain from laparoscopic surgery.

摘要

目的

本研究为前瞻性、多中心队列研究,旨在评估荷兰实施腹腔镜子宫切除术(LH)对术后 6 个月内生活质量(QOL)的影响。

方法

本研究纳入了因良性疾病或早期低危子宫内膜癌需要接受 LH 的女性患者。采用 36 项简明健康调查量表(SF-36)在术前、术后 6 周和 6 个月时测量 QOL。将平均 QOL 值与未选择的、女性、荷兰参考人群进行比较。应用纵向线性混合模型评估 LH 后 QOL 的变化,并确定≥65 岁患者的 QOL 评分是否存在差异。

结果

本研究共纳入 116 例患者的数据进行分析。手术时的中位年龄为 54 岁(范围 34-83 岁),四分位间距为 43-65 岁。LH 后 6 个月,所有 QOL 值均高于术前,且与参考人群相当或更高。年龄较大的女性术前 QOL 评分较高,术后评分仍较高。

结论

LH 后 QOL 得到改善。年龄较大的女性术前报告 QOL 值较高,术后 6 个月 QOL 仍较高。年龄不会对 LH 后 QOL 产生负面影响,不应成为避免腹腔镜手术的理由。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/606e/6296188/713368f57fc3/cia-13-2517Fig1.jpg

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