Impact of the method of reconstruction after oncologic oesophagectomy on quality of life - a prospective, randomised study

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Abstract

Objective: For patients undergoing oncologic surgery, the quality of life (QoL) is generally accepted as an important outcome parameter in addition to long-term survival, mortality and complication rates. This study focussed on the QoL in patients after oesophagectomy for cancer, comparing the method of reconstruction (narrow gastric tube vs whole stomach). Methods: In a prospective randomised single-centre study from 2007 to 2008, 104 patients underwent oesophagectomy for cancer. To assess the QoL, a questionnaire in reference to the EORTC-QLQ-C30 and the QLQ-OES24 was administered at 3 weeks, 6 months and 1 year after surgery. Clinical data were collected prospectively, and follow-up was performed regularly. Results: There were no significant differences between the narrow gastric tube group (NGT group, n=52) and the whole-stomach group (WS group, n=52) with regard to patient and cancer characteristics, operative procedure, postoperative intensive care unit (ICU) hospitalisation, and overall survival at 1 year. Regarding the postoperative complication, there were more cases of postoperative reflux oesophagitis and impairment of pulmonary function in the WS group (P< 0.05). Regarding the QoL investigation, the scores of QoL dropped for all patients at 3 weeks after surgery. Slowly, recovery was found at both 6 months and 1 year in both groups. Patients in the NGT group reported significantly (P< 0.05) better scores of QoL at both 6 months and 1 year. Conclusions: Patients who underwent gastric tube reconstruction develop less postoperative digestive tract complications, and have a quicker recovery and a better QoL during the follow-up period. Further investigation and data collection will allow the assessment of this procedure beyond 1 year after operation. © 2010 European Association for Cardio-Thoracic Surgery.

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Zhang, C., Wu, Q. C., Hou, P. Y., Zhang, M., Li, Q., Jiang, Y. J., & Chen, D. (2011). Impact of the method of reconstruction after oncologic oesophagectomy on quality of life - a prospective, randomised study. European Journal of Cardio-Thoracic Surgery, 39(1), 109–114. https://doi.org/10.1016/j.ejcts.2010.04.032

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