Esophagectomy for cancer has a negative impact on health-related quality of life.
However, factors influencing postoperative health-related quality of life have been sparsely studied.
|Dysphagia was similar in patients who had handsewn and stapled anastomoses|
|The British Journal of Surgery|
Dr Rutegård and colleagues from Sweden explored how selected surgical factors affected health-related quality of life 6 months after operation.
This population-based study was based on a Swedish network of physicians with almost complete nationwide coverage.
Data on esophageal cancer surgery was collected prospectively between 2001 and 2005.
Patients completed validated health-related quality of life questionnaires 6 months after operation.
The team calculated mean scores with 95% confidence intervals and clinically relevant differences between groups were analyzed in a linear regression model, adjusted for potential confounders.
The team included 355 patients in the analysis.
Extensive surgery, as indicated by a transthoracic approach, and more extensive lymphadenectomy were not associated with worse health-related quality of life measures.
The researchers found that wider resection margins, and a longer duration of operation were also not associated with worse health-related quality of life measures than less extensive operations.
The team noted that dysphagia was similar in patients who had handsewn and stapled anastomoses.
Technical surgical complications had significant deleterious effects on several aspects of health-related quality of life.
Dr Rutegård's team concluded, "This study provides no evidence to suggest that less extensive surgery for esophageal cancer should be recommended from the perspective of health-related quality of life."
"It is essential, however, that attention be paid to minimizing technical surgical complications."