Health-related quality of life after minimally invasive oesophagectomy.
BACKGROUND
Open oesophagectomy has a detrimental impact on health-related quality of life (HRQL), with recovery taking up to a year. Minimally invasive oesophagectomy (MIO) may enable a more rapid recovery of HRQL.


METHODS
Clinical outcomes from consecutive patients undergoing MIO for cancer were recorded between April 2005 and April 2007. Patients completed validated questionnaires, European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-OES18, before surgery and at 6 weeks, 3, 6 and 12 months after surgery.


RESULTS
MIO for cancer or high-grade dysplasia was planned in 62 patients, but abandoned in four owing to occult metastatic disease. Resection was completed in the remaining 58, two having partial conversion to open surgery. There was one in-hospital death and 29 patients developed complications. At 1 year, 52 of 58 patients were alive. Questionnaire response rates were high at each time point (overall compliance 84 per cent). Six weeks after MIO, patients reported deterioration in functional aspects of HRQL and more symptoms than at baseline. However, most improved by 3 months and had returned to baseline levels by 6 months. These levels were maintained 1 year after surgery, with 85 per cent of patients recovering in more than 50 per cent of the HRQL domains.


CONCLUSIONS
MIO leads to a rapid restoration of HRQL.
Department of Thoracic and Upper Gastrointestinal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
R
R
Parameswaran
J M
JM
Blazeby
R
R
Hughes
K
K
Mitchell
R G
RG
Berrisford
S A
SA
Wajed
D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D004938:Esophageal Neoplasms / Q000523:psychology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods / Q000523:psychology*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000523:psychology*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D013274:Stomach Neoplasms / Q000523:psychology / Q000601:surgery*