Comparison of clinical outcomes and quality of life between laparoscopic and open central pancreatectomy with pancreaticojejunostomy
Autor: | Weiwei Jin, Yi-Ping Mou, Bin Zhang, Chao Lu, Jiayu Zhou, Yu-Cheng Zhou, Xiao-Wu Xu, Ren-Chao Zhang, Chaojie Huang |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Operative Time 030230 surgery 03 medical and health sciences Pancreatectomy Postoperative Complications 0302 clinical medicine Quality of life Blood loss Pancreaticojejunostomy Surveys and Questionnaires Laparotomy Internal medicine medicine Humans Laparoscopy Pancreas Aged medicine.diagnostic_test business.industry Length of Stay Middle Aged Hepatology medicine.disease Surgery Pancreatic Neoplasms Treatment Outcome Pancreatic fistula 030220 oncology & carcinogenesis Quality of Life Female business Abdominal surgery |
Zdroj: | Surgical Endoscopy. 31:4756-4763 |
ISSN: | 1432-2218 0930-2794 |
Popis: | The studies comparing laparoscopic and open central pancreatectomy with pancreaticojejunostomy are limited. This study aimed to compare clinical outcomes and quality of life of patients undergoing laparoscopic and open central pancreatectomy with pancreaticojejunostomy. Between December 1997 and December 2015, patients who underwent central pancreatectomy with pancreaticojejunostomy were reviewed. Patients were divided into 2 groups as laparoscopic central pancreatectomy (LCP) and open central pancreatectomy (OCP). Data considered for comparison analysis were patient demographics, intraoperative variables, morbidity, postoperative hospital stay, mortality, pathologic findings, and quality of life (SF-36 questionnaire). Thirty-six patients (17 LCP and 19 OCP) were included in the final analysis. Baseline characteristics were similar in the 2 groups. The operating time (280.4 ± 33.6 vs. 290.5 ± 62.5 min, p = 0.455) were similar between two groups. LCP group showed significantly lower estimated blood loss (76.4 ± 70.3 vs. 390.3 ± 279.0 ml, p = 0.001), shorter first flatus time (2.4 ± 0.9 vs. 3.9 ± 1.3 days, p = 0.001), and shorter diet start time (4.1 ± 2.2 vs. 6.1 ± 2.4 days, p = 0.030). However, the postoperative hospital stay was not significantly different between two groups (15.6 ± 12.1 vs. 24.0 ± 27.5 days, p = 0.347). Postoperative outcomes, including morbidity (58.8 vs. 52.6%, p = 0.749), pancreatic fistula rates (≥grade B: 17.6 vs. 36.8%, p = 0.106), and mortality, were similar in the 2 groups. The median follow-up period was 45 months (range 4–216 months). No local recurrence or distant metastasis was detected in either group. On the follow-up survey, the total quality of life score (702.9 ± 47.9 vs. 671.8 ± 94.1), physical health score (353.9 ± 24.8 vs. 326.6 ± 67.6) and mental health score (349.0 ± 26.5 vs. 345.2 ± 34.6) were higher in the LCP group compared with the OCP group. However, these differences were not statistically significant (p > 0.05). The score in role physical (100 vs. 73.1 ± 4.8, p = 0.042) was significantly higher in LCP group, and not statistically significant in other areas (p > 0.05). LCP with pancreaticojejunostomy is safe and feasible for benign or borderline malignant lesions in the pancreatic neck and proximal body. Compared to OCP, LCP is associated with lower estimated blood loss, faster recovery, and better quality of life. |
Databáze: | OpenAIRE |
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