Surgical Outcomes Research Centre (SOuRCe), University of Sydney & Sydney Local Health District, New South Wales, Australia; Data Analysis Surgical Outcomes Unit (DASO), Royal North Shore Hospital, Sydney, New South Wales, Australia.
Surgical Outcomes Research Centre (SOuRCe), University of Sydney & Sydney Local Health District, New South Wales, Australia.
Eur J Surg Oncol. 2021 Dec;47(12):3137-3143. doi: 10.1016/j.ejso.2021.07.022. Epub 2021 Jul 27.
To describe the long-term course of pain and fatigue in patients undergoing pelvic exenteration and to evaluate potential prognostic factors for these outcomes.
Prospective cohort study.
Royal Prince Alfred Hospital, Sydney, Australia.
Consecutive patients undergoing pelvic exenteration surgery between July 2008 and December 2017.
Pain and fatigue scores collected via SF-36v2 Health surveys pre-operatively and at eight time-points post-operatively for a period of 5-years. The course of pain and fatigue were described according to the following prognostic factors; bone resection (yes/no), cancer type (primary/recurrent), margin status (R0/R1-2) and extent of exenteration (complete/partial).
345 of 459 eligible patients (75 %) consented to the study. The course of pain and fatigue over the 5 year follow-up was favourable. Patients undergoing pelvic exenteration with an R0 resection margin or without bone resection presented lower pain levels throughout the follow-up period. Bone resection, positive surgical margin (R1/R2) and type of cancer did not influence fatigue trajectories. Patients undergoing complete pelvic exenteration were more likely to report a higher level of pain and fatigue in the initial follow-up period, however this difference was not observed in the longer-term.
Patients undergoing PE (Austin and Solomon, 2015) [1] can expect improvement but an incomplete recovery in the levels of pain and fatigue postoperatively over the 5-year follow-up period. Bone resection as part of exenteration demonstrated higher levels of pain and fatigue.
描述接受盆腔廓清术患者的疼痛和疲劳的长期病程，并评估这些结局的潜在预后因素。
前瞻性队列研究。
澳大利亚悉尼皇家阿尔弗雷德王子医院。
2008 年 7 月至 2017 年 12 月连续接受盆腔廓清术的患者。
术前和术后 8 个时间点通过 SF-36v2 健康调查收集的疼痛和疲劳评分，为期 5 年。根据以下预后因素描述疼痛和疲劳的病程：骨切除（是/否）、癌症类型（原发性/复发性）、切缘状态（R0/R1-2）和廓清术范围（完全/部分）。
459 名符合条件的患者中有 345 名（75%）同意参与该研究。在 5 年的随访中，疼痛和疲劳的病程是有利的。接受 R0 切除边缘或无骨切除的盆腔廓清术患者在整个随访期间疼痛程度较低。骨切除、阳性手术切缘（R1/R2）和癌症类型均不影响疲劳轨迹。接受完全盆腔廓清术的患者在初始随访期间更有可能报告更高水平的疼痛和疲劳，但在较长时间内没有观察到这种差异。
接受盆腔廓清术的患者（Austin 和 Solomon，2015 年）[1]可以预期在术后 5 年的随访期间疼痛和疲劳水平会有所改善，但不会完全恢复。作为廓清术一部分的骨切除表现出更高水平的疼痛和疲劳。
