Treider Martin Alavi, Røkkum Henrik, Sæter Thorstein, Bjørnland Kristin
Oslo University Hospital, Department of Gastro-and Pediatric Surgery, Norway; University of Oslo, Faculty of Clinical Medicine, Norway.
Oslo University Hospital, Department of Gastro-and Pediatric Surgery, Norway; University of Oslo, Faculty of Clinical Medicine, Norway.
J Pediatr Surg. 2025 Jan;60(1):161938. doi: 10.1016/j.jpedsurg.2024.161938. Epub 2024 Sep 20.
Congenital duodenal obstruction (CDO) is one of the most common gastrointestinal congenital anomalies. Still, patient-reported long-term results are limited. The aims of this study were to evaluate the long-term gastrointestinal quality of life (QoL), generic QoL, patient-reported scar appearance, and reinterventions after CDO repair.
Patients who underwent surgery for CDO in Norway from 1995 to 2020 were invited to answer the validated questionnaires PedsQL and PedsQL gastrointestinal symptom scale and a study-specific questionnaire on general health and scar assessment. Parent-proxy reports were used for patients <12 years and patients with cognitive impairment. Scores were compared with an American and Norwegian control group for gastrointestinal and generic QoL, respectively.
Of 186 eligible patients, eight were deceased, 25 had unretrievable contact information, and 79 did not respond. There were no significant differences between included (n = 74) and not included (n = 112) patients regarding baseline data. The mean follow-up time was 13.3 (SD = 6.6) years. Patients with CDO had significantly lower overall gastrointestinal QoL than controls (85.9 versus 90.0, p = 0.010). The most common symptoms were gas/bloating, constipation, food/drink limits, and reflux. Generic QoL was similar between the CDO population and controls (84.4 versus 85.3, p = 0.530). Twenty-one (28 %) patients had some degree of pain and/or concern related to the surgical scar. Nine (12 %) patients had reoperations related to the CDO repair; four due to adhesive small bowel obstruction.
A notable portion of patients report troublesome gastrointestinal symptoms and cosmetic concerns regarding their surgical scar after CDO repair. Even so, generic QoL was good.
IV.
先天性十二指肠梗阻（CDO）是最常见的胃肠道先天性畸形之一。然而，患者报告的长期结果有限。本研究的目的是评估先天性十二指肠梗阻修复术后的长期胃肠道生活质量（QoL）、一般生活质量、患者报告的疤痕外观以及再次干预情况。
邀请1995年至2020年在挪威接受CDO手术的患者回答经过验证的问卷儿童生活质量量表（PedsQL）和儿童生活质量量表胃肠道症状量表，以及一份关于总体健康和疤痕评估的特定研究问卷。12岁以下患者和有认知障碍的患者采用家长代答报告。分别将得分与美国和挪威的胃肠道和一般生活质量对照组进行比较。
在186名符合条件的患者中，8人死亡，25人无法获取联系信息，79人未回复。纳入研究的患者（n = 74）和未纳入研究的患者（n = 112）在基线数据方面无显著差异。平均随访时间为13.3（标准差 = 6.6）年。CDO患者的总体胃肠道生活质量显著低于对照组（85.9对90.0，p = 0.010）。最常见的症状是气体/腹胀、便秘、饮食限制和反流。CDO患者群体和对照组的一般生活质量相似（84.4对85.3，p = 0.530）。21名（28%）患者对手术疤痕有一定程度的疼痛和/或担忧。9名（12%）患者因CDO修复进行了再次手术；4例是由于粘连性小肠梗阻。
相当一部分患者报告称，CDO修复术后存在令人烦恼的胃肠道症状以及对手术疤痕的美容问题担忧。即便如此，一般生活质量良好。
IV级
