Quality of life after emergency vs. elective esophagectomy with cervical reconstruction.
BACKGROUND
Esophagectomy with reconstruction by collar anastomosis has an impact on the patients quality of life (QOL). The aim of this study was to explore a potential difference in QOL between elective and emergency esophagectomy with collar reconstruction.


METHODS
Quality of life questionnaires were evaluated in 17 patients prior to esophagectomy, shortly after surgery, hospital discharge, and at least > 9 months after surgery using the EORTC QLQ C30 and EORTC OES 18 forms. In all patients reconstruction was per-formed by high collar anastomosis. Patients in group A received elective esophageal resection. In group B emergency esophagectomy was performed because of esophageal perforation for various reasons apart from cancer. In this group, delayed reconstruction was performed in a second operation 3-6 months after esophagectomy.


RESULTS
There was a temporary decrease of postoperative QOL in both groups, which re-turned to preoperative values in the follow-up except for physical functioning, which remained decreased in group A (p < 0,05). There were no persisting differences in QOL after elective and emergency esophagectomy in the follow-up.


CONCLUSIONS
Patients with elective and emergency esophagectomy and reconstruction by high collar anastomosis gained a good long-term QOL in our cohort of patients. This gives evidence that the observed QOL after elective resection of esophageal cancer is not only caused by a relief of cancer burden, but also due to a surgical procedure which is able to provide a good long-term QOL.
Schneider
L
L
Department of General Surgery, University of Heidelberg, Heidelberg, Germany. Lutz.Schneider@med.uni-heidelberg.de
Hartwig
W
W
Aulmann
S
S
Lenzen
Ch
Ch
Strobel
O
O
Fritz
S
S
Hackert
T
T
Keller
M
M
Buchler
M W
MW
Werner
J
J
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D044964:Cervicoplasty; D003106:Colon / Q000601:surgery; D017558:Elective Surgical Procedures; D004935:Esophageal Diseases / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007441:Intubation, Gastrointestinal; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome