Higher quality of life after metal stent placement compared with plastic stent placement for malignant extrahepatic bile duct obstruction: a randomized controlled trial
| Autor: | Menno A. Brink, Meike M. Hirdes, Jan Nicolai, Robbert C.H. Scheffer, Petra G. Van Boeckel, Frank Wolters, Joyce Alderliesten, Frans Peters, Jeroen M. Jansen, Ronald Breumelhof, M. J.M. Groenen, Alexander Bodelier, Niels G. Venneman, Daisy Walter, Anne M. May, Ewout W. Steyerberg, Adriaan C.I.T.L. Tan, Gi Tan, Max Leenders, Laurens A. van der Waaij, Frank P. Vleggaar, Bas L. Weusten, Wim Laleman, Peter D. Siersema, Ben J.M. Witteman |
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| Přispěvatelé: | Public Health |
| Rok vydání: | 2017 |
| Předmět: |
Male
Palliative care medicine.medical_treatment bile ducts law.invention Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] 0302 clinical medicine Quality of life Randomized controlled trial Self-expandable metallic stent law Surveys and Questionnaires Medicine Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Cholestasis QLQ-C30 Palliative Care Gastroenterology PALLIATION Middle Aged PANCREATIC-CANCER humanities Multicenter Study 030220 oncology & carcinogenesis Randomized Controlled Trial 030211 gastroenterology & hepatology Female Stents medicine.symptom Plastics medicine.medical_specialty Nausea Self Expandable Metallic Stents 03 medical and health sciences Multicenter trial Journal Article Humans Bile ducts Comparative Study BILIARY OBSTRUCTION Aged Hepatology business.industry Stent CANCER CLINICAL-TRIALS Cholestasis Extrahepatic medicine.disease Surgery Pancreatic Neoplasms Quality of Life business cholestasis |
| Zdroj: | European Journal of Gastroenterology & Hepatology, 29, 231-237 European Journal of Gastroenterology & Hepatology, 29, 2, pp. 231-237 European Journal of Gastroenterology and Hepatology, 29(2), 231. Lippincott Williams and Wilkins European Journal of Gastroenterology & Hepatology, 29(2), 231-237. Lippincott Williams & Wilkins European journal of gastroenterology & hepatology, 29(2), 231-237. Lippincott Williams and Wilkins |
| ISSN: | 0954-691X |
| Popis: | Objective For palliation of extrahepatic bile duct obstruction, self-expandable metal stents (SEMS) are superior to plastic stents in terms of stent patency and occurrence of stent dysfunction. We assessed health-related quality of life (HRQoL) after stent placement to investigate whether this also results in a difference in HRQoL between patients treated with a plastic stent or SEMS.Patients and methods This randomized multicenter trial included 219 patients who were randomized to receive plastic stent (n = 73) or SEMS [uncovered (n = 75) and covered (n = 71); n = 146] placement. HRQoL was assessed with two general questionnaires (EQ-5D-3L and QLQ-C30) and one disease-specific questionnaire (PAN-26). Scores were analyzed using linear mixed model regression and included all patients with baseline and at least one follow-up measurement.Results HRQoL data were available in 140 of 219 patients (64%); 71 patients (32%) declined participation and in eight patients (4%) only baseline questionnaires were available. On the QLQ-C30, the interaction between follow-up time and type of stent was significantly different on two of five functional scales [physical functioning (P = 0.004) and emotional functioning (P = 0.01)] in favor of patients with a SEMS. In addition, patients with SEMS reported significantly less frequent symptoms of fatigue (P = 0.01), loss of appetite (P = 0.02), and nausea and vomiting (0.04) over time. The EQ-VAS score decreased with time in both treatment groups, indicating a statistically significant decrease in HRQoL over time.Conclusion In patients with inoperable malignant extrahepatic bile duct obstruction, SEMS placement results in better scores for general and disease-specific HRQoL over time compared with plastic stent placement. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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