title: Esophageal reconstruction for benign disease: self-assessment of functional outcome and quality of life.
abstract: BACKGROUND
  Little information exists regarding functional outcome and quality of life after esophagectomy and subsequent esophageal reconstruction for benign disease as evaluated by the patients themselves.
  
  
  METHODS
  Eighty-one patients completed a combined two-part questionnaire regarding esophageal function and quality of life (MOS SF-36) a median of 9.8 years (range, 10 months to 18.9 years) after esophageal reconstruction for benign disease. There were 43 men (53.1%) and 38 women (46.9%). Median age at time of esophageal reconstruction was 51 years (range, 6 to 78 years). Intestinal continuity was established with stomach in 58 patients (71.6%), colon in 16 patients (19.8%), and small bowel in 7 patients (8.6%).
  
  
  RESULTS
  Dysphagia to solids was present in 48 patients (59.3%) and 27 patients (33.3%) required at least one postoperative dilatation. Heartburn was present in 50 patients (61.7%) which required medication for control in 37 patients (45.7%). The number of meals per day was three to four in 58 patients (71.6%), more than four in 15 patients (18.5%), less than three in 6 patients (7.4%), and unknown in 2 patients (2.5%). The size of each meal was smaller than preoperatively in 46 patients (56.8%), larger in 22 patients (27.2%), unchanged in 12 patients (14.8%), and unknown in 1 patient (1.2%). The number of bowel movements per day increased in 37 patients (45.7%), was unchanged in 36 patients (44.4%), and decreased in 8 patients (9.9%). Resection for perforation was associated with smaller postoperative meals compared with resection for stricture (p < 0.05). Age, sex, and type of esophageal reconstruction did not affect late functional outcome. Regarding quality of life, physical functioning, social functioning, and health perception were decreased (p < 0.05). No significant change was observed in role-physical, mental health, bodily pain, energy/fatigue, and role-emotional scores.
  
  
  CONCLUSIONS
  Self-assessment of postoperative esophageal symptoms after esophagectomy and reconstruction for benign disease demonstrates that symptoms are frequently present at long-term follow-up and unaffected by the type of reconstruction.
authors.affiliation: Division of General Thoracic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Young
authors.forename: C
authors.initials: C
authors.lastname: Deschamps
authors.forename: M S
authors.initials: MS
authors.lastname: Allen
authors.forename: D L
authors.initials: DL
authors.lastname: Miller
authors.forename: V F
authors.initials: VF
authors.lastname: Trastek
authors.forename: C D
authors.initials: CD
authors.lastname: Schleck
authors.forename: P C
authors.initials: PC
authors.lastname: Pairolero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003680:Deglutition Disorders / Q000209:etiology; D004935:Esophageal Diseases / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life