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Systematic review of health-related quality of life after esophagectomy for esophageal cancer

World Journal of Gastroenterology 2011年第42期17卷 4660-4674页

作者： Marco Scarpa Stefano Valente Rita Alfieri Matteo Cagol Giorgio Diamantis Ermanno Ancona Carlo Castoro Oncological Surgery Unit Veneto Institute of Oncology department of gastroint estinal and surgical sciences University of Padova

This study is aimed to assess the long-term health-related quality of life(HRQL) of patients after esopha-gectomy for esophageal cancer in comparison with es-tablished norms,and to evaluate changes in HRQL during the different stages of follow-up after esopha-geal resection. A systematic review was performed bysearching medical databases(Medline,Embase andthe Cochrane Library) for potentially relevant studiesthat appeared between January 1975 and March *** were included if they addressed the questionof HRQL after esophageal resection for esophage alcancer. Two researchers independently performed the study selection,data extraction and analysis ***-one observational studies were included witha total of 1282(12-355) patients. Five studies were performed with short form-36(SF-36) and 16 with European Organization for Research and Treatment of Cancer(EORTC) QLQ C30(14 of them also utilized the disease-specific OES18 or its previous version OES24) .The analysis of long-term generic HRQL with SF-36showed pooled scores for physical,role and socialfunction after esophagectomy similar to United Statesnorms,but lower pooled scores for physical function,vitality and general health perception. The analysis of HRQL conducted using the Global EORTC C30 globalscale during a 6-mo follow-up showed that global scaleand physical function were better at the baseline. The symptom scales indicated worsened fatigue,dyspneaand diarrhea 6 mo after esophagectomy. In contrast,however,emotional function had significantly improved after 6 mo. In conclusion,short- and long-term HRQLis deeply affected after esophagectomy for cancer. The impairment of physical function may be a long-termconsequence of esophagectomy involving either the respiratory system or the alimentary tract. The short-and long-term improvement in the emotional function of patients who have undergone successful operationsmay be attributed to the impression that they have survived a near-death experience.

关键词：呼吸系统食管癌生活质量健康 MEDLINE 生理功能全球范围数据提取

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Peritoneal adhesions after laparoscopic gastrointestinal surgery

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World Journal of Gastroenterology 2014年第17期20卷 4917-4925页

作者： Valerio Mais Division of Gynecology Obstetrics and Pathophysiology of Human ReproductionDepartment of Surgical SciencesUniversity of Cagliari09124 CagliariItaly

Although laparoscopy has the potential to reduce peritoneal trauma and post-operative peritoneal adhesion formation,only one randomized controlled trial and a few comparative retrospective clinical studies have addressed this *** reduces de novo adhesion formation but has no efficacy in reducing adhesion reformation after ***,several studies have suggested that the reduction of de novo post-operative adhesions does not seem to have a significant clinical *** data in animal models have suggested that CO2 pneumoperitoneum can cause acute peritoneal inflammation during laparoscopy depending on the insufflation pressure and the surgery *** peritoneal cavity protection by the insufflation of a low-temperature humidified gas mixture of CO2,N2O and O2 seems to represent the best approach for reducing peritoneal inflammation due to ***,these experimental data have not had a significant impact on the modification of laparoscopic *** contrast,surgeons should train themselves to perform laparoscopy quickly,and they should complete their learning curves before testing chemical anti-adhesive agents and antiadhesion *** anti-adhesive agents have the potential to exert broad peritoneal cavity protection against adhesion formation,but when these agents are used alone,the concentrations needed to prevent adhesions are too high and could cause major postoperative side ***-adhesion barriers have been used mainly in open surgery,but some clinical data from laparoscopic surgeries are already ***,gels,and fluid barriers are easier to apply in laparoscopic surgery than solid *** have been encouraging with solid barriers,spray barriers,and gel barriers,but they have been ambiguous with fluid ***,when barriers have been used alone,the maximum protection against adhesion formation has been no greater than 60%.A recent small,randomized c

关键词： Peritoneal adhesions Laparoscopy Abdomen gastroint

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