Abstract
To investigate the influence of the operative procedures of reconstruction after resection of esophageal cancer on the postoperative quality of life, an interview was conducted and subjective and objective factors related to the quality of life were evaluated in 50 patients without a recurrence of esophageal cancer. Among the 50 cases, reconstruction by the antethoracal route was performed in 9 (group I) and by the retrosternal route in 24 (group II). Intrathoracic anastomosis was done in 17 (group III). A postoperative disturbance of the food passage was seen 22.0, 41.6, and 5.9% in groups I, II, and III, respectively. Dumping symptom was evident 11.1, 12.5, and 11.8%, respectively. Heartburn was seen only in two cases, in group III. A body weight loss of more than 1.0 kg from preoperative weight was seen in 33.3, 41.7, and 41.2% of groups I, II, and III, respectively. There was no difference in the postoperative performance status or laboratory data among the groups. Thus, although intrathoracic anastomosis was favorable for postoperative food passage, there was no significant difference in any other factors in the quality of life among the routes of reconstruction, and the quality of life gradually improved in patients of all groups as postoperative time passed in the cases without postoperative recurrence of esophageal cancer.
Résumé
Pour étudier l'influence des différentes techniques de reconstruction après résection pour cancer de l'esophage sur la qualité de vie postopératoire, on a interviewé 50 patients opérés et indemnes de récidive. Parmi ceux-ci, 9 avaient eu une reconstruction en position présternale (group 1), 24 par une voie rétrosternale (groupe 2) alors que 17 avaient eu une anastomose intrathoracique (groupe 3). Des difficultés d'alimentation ont été observées chez respectivement 22; 41.6 et 5.% des patients dans les groupes 1, 2 et 3. Un syndrome de dumping a été observé chez respectivement 11.1, 12.5 et 11.8%. Un pyrosis n'a été noté que dans deux cas du groupe 3. Une perte de poids supérieure à un Kg a été observée chez respectivement 33.3, 41.7 et 41.2% des patients. Il n'y avait aucune différence postopératoire en ce qui concerne les tests de performance ou les tests de laboratoire. En conclusion, bien que la voie intrathoracique soit la meilleure en ce qui concerne l'alimentation, il n'y avait aucune différence quant à la qualité de vie pour les trois techniques.La qualité de vie s'est amélioré progrèssivement chez tous les patients quelle que soit la technique employée s'il n'avait pas de récidive.
Resumen
Con el propósito de determinar la influencia sobre la calidad de vida de los procedimientos operatorios de reconstrucción luego de la resección de un cancer esofágico, se realizaron entrevistas para valorar los factores tanto subjetivos como objetivos relativos a la calidad de la vida en 50 pacientes libres de enfermedad recurrente. En este grupo de 50 pacientes se practicó reconstrucción por la vía anterotorácica en 9 (Grupo I), por la ruta retroesternal en 24 (Grupo II) y se practicó anastomosis intratorácica en 17 (Grupo III). Se demostró alteración en el paso de los alimentos en 22.0%, 41.6% y 5.9% en los Grupos I, II y III, repectivamente; se evidenciaron sítomas de “dumping” en 11.1%, 12.5% y 11.8% en cada grupo. Sólo se encontró pirosís en dos casos en el Grupo III. Pérdida de peso mayor de 1.0 kg frente al peso preoperatorio fue obsevada en 33.3%, 41.7% y 41.2%, respectivamente. No hubo diferencia en cuanto a la actividad física postoperatoria ni en los hallazgos de laboratorio entre los grupos. Por lo tanto, aunque la anastomosís intratorácica es más favorable en cuanto al buen paso de los alimentos, no se evidencian diferencias significativas en los demás factores pertinentes a calidad de vida entre las diferentes rutas de reconstrucción, y la calidad de la vida mejoró paulatinamente en todos los grupos con el paso del tiempo en estos pacientes libres de recurrencia postoperatoria de su cáncer esofágico.
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Kuwano, H., Ikebe, M., Baba, K. et al. Operative procedures of reconstruction after resection of esophageal cancer and the postoperative quality of life. World J. Surg. 17, 773–776 (1993). https://doi.org/10.1007/BF01659093
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DOI: https://doi.org/10.1007/BF01659093