Bleicher Josh, Place Aubrey, Harris Alex H S, Scaife Courtney L, Huang Lyen C
Department of General Surgery, University of Utah, Salt Lake City, UT.
Department of Surgery, Stanford University, Stanford, CA.
Ann Surg Open. 2022 Oct 25;3(4):e214. doi: 10.1097/AS9.0000000000000214. eCollection 2022 Dec.
Pancreatic adenocarcinoma (PDAC) remains a highly lethal disease, with surgery, the only opportunity for cure, accompanied by high rates of morbidity. Understanding patients' lived experiences after surgical resection of PDAC is critical to knowing whether the decision to undergo surgery was worth it for these patients.
We performed a convergent, mixed-methods study with patients who underwent resection of PDAC between January 1, 2019, and January 8, 2020. Quantitative data (medical record review and 3 questionnaires) were analyzed using descriptive statistics. Qualitative data (semistructured interviews) were analyzed using the constant comparative method. Data were then compared for congruence.
Eighteen of 22 eligible participants completed interviews and 11 completed questionnaires. Data collection occurred at a median of 14.2 months (IQR 11.6-16.3) from surgery. We identified 4 main themes. First, persistent negative symptoms were common for patients, but patients adapt to these and are satisfied with their "new normal." Second, patients have varied and continually evolving mindsets throughout their cancer journey. Third, despite decreased quality-of-life, patients have a high degree of satisfaction with their decision to pursue surgery. Finally, patients were okay with a passive role in decision-making around surgery. Despite variable involvement in decision-making and outcomes, no participants reported regret over the decision to pursue surgery.
This nuanced account of patients' lived experiences following surgery for PDAC allows for an improved understanding of the impact of pancreatic resection on patients. Surgeons can use these data to improve preoperative counseling for patients with PDAC and help guide them to making the correct decisions about surgery.
胰腺腺癌（PDAC）仍然是一种高致死性疾病，手术作为唯一的治愈机会，却伴随着高发病率。了解PDAC手术切除后患者的生活经历对于判断手术决策对这些患者是否值得至关重要。
我们对2019年1月1日至2020年1月8日期间接受PDAC切除术的患者进行了一项收敛性混合方法研究。定量数据（病历审查和3份问卷）采用描述性统计进行分析。定性数据（半结构化访谈）采用持续比较法进行分析。然后比较数据的一致性。
22名符合条件的参与者中有18名完成了访谈，11名完成了问卷。数据收集发生在手术后的中位数14.2个月（四分位间距11.6 - 16.3）。我们确定了4个主要主题。首先，持续的负面症状对患者来说很常见，但患者会适应这些症状并对他们的“新常态”感到满意。其次，患者在整个癌症历程中有着不同且不断演变的心态。第三，尽管生活质量下降，但患者对接受手术的决定高度满意。最后，患者对手术决策中的被动角色表示认可。尽管在决策参与度和结果方面存在差异，但没有参与者对接受手术的决定表示后悔。
这种对PDAC手术后患者生活经历的细致描述有助于更好地理解胰腺切除术对患者的影响。外科医生可以利用这些数据改善对PDAC患者的术前咨询，并帮助指导他们做出关于手术的正确决策。
