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胰腺良性和恶性病变手术后的长期生活质量和全球健康状况。

Long-term quality of life and global health following pancreatic surgery for benign and malignant pathologies.

机构信息

Division of GI/Endocrine Surgery, Department of Surgery, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY. Electronic address: https://twitter.com/KaitlinShawMPH.

Division of GI/Endocrine Surgery, Department of Surgery, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.

出版信息

Surgery. 2021 Sep;170(3):917-924. doi: 10.1016/j.surg.2021.03.023. Epub 2021 Apr 21.

Abstract

BACKGROUND

While the frequency of pancreatic operations are increasing, understanding quality of life is still insufficient. The aim was to evaluate global health and quality of life of long-term survivors from a range of pancreatic operations using internationally validated instruments.

METHODS

Patients surviving longer than 5 years after pancreatic operations were surveyed using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Cancer-30 and Pancreatic Cancer-26 modules. Variables were analyzed according to demographic and clinical features.

RESULTS

Eighty patients completed questionnaires. The median follow-up was 9.3 years from the time of operation. The mean scores of global health status/quality of life, physical function, role function, emotional function, cognitive function, and social functioning were 73.9, 83.7, 84.6, 81.1, 80.2, and 86.3, respectively. The participants' reported quality of life was comparable or better than the general United States population. The summary score, which was defined as weighted average of function and symptom scores (excluding global health status/quality of life and financial impact scores), showed significant differences according to the level of education (70.1 no college vs 85.2 college and 85.7 grad school, P = .049), operation type (79.9 pancreatoduodenectomy vs 91.1 total, P = .043), additional endoscopic retrograde cholangiopancreatography (77.3 vs 86.0, P = .029), and additional abdominal operations related to the primary operation (79.0 vs 86.6, P = .026).

CONCLUSION

Long-term survivors of pancreatectomy had comparable or better global health status/quality of life, function scale, and lower symptom scores than the general population of the United States, though persistent gastrointestinal symptoms are common. These findings should help inform patients of the long-term consequences of pancreatectomy, so they can make better decisions especially when considering prophylactic operations.

摘要

背景

尽管胰腺手术的频率在增加,但对生活质量的了解仍然不足。目的是使用国际认可的工具评估各种胰腺手术后长期存活者的整体健康状况和生活质量。

方法

使用欧洲癌症研究与治疗组织生活质量问卷癌症 30 项和胰腺癌 26 项模块对胰腺手术后生存时间超过 5 年的患者进行调查。根据人口统计学和临床特征分析变量。

结果

80 例患者完成了问卷。从手术时间开始的中位随访时间为 9.3 年。总体健康状况/生活质量、身体功能、角色功能、情感功能、认知功能和社会功能的平均得分为 73.9、83.7、84.6、81.1、80.2 和 86.3。参与者报告的生活质量与美国一般人群相当或更好。综合评分定义为功能和症状评分的加权平均值(不包括总体健康状况/生活质量和经济影响评分),根据教育程度(70.1 无大学学历与 85.2 大学学历和 85.7 研究生学历,P=0.049)、手术类型(79.9 胰十二指肠切除术与 91.1 全胰切除术,P=0.043)、附加内镜逆行胰胆管造影(77.3 与 86.0,P=0.029)和与原发手术相关的附加腹部手术(79.0 与 86.6,P=0.026)存在显著差异。

结论

胰切除术的长期幸存者的总体健康状况/生活质量、功能评分和较低的症状评分与美国一般人群相当或更好,尽管持续存在胃肠道症状很常见。这些发现应该有助于向患者告知胰切除术的长期后果,以便他们能够做出更好的决策,特别是在考虑预防性手术时。

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