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Patient-Reported Lo...
Patient-Reported Long-Term Outcome is Superior After Treatment with Self-Expanding Metallic Stents in Esophageal Perforations
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- Waltersten, M. (author)
- Uppsala universitet,Institutionen för kirurgiska vetenskaper
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- Sundbom, Magnus (author)
- Uppsala universitet,Gastrointestinalkirurgi
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(creator_code:org_t)
- 2020-09-28
- 2021
- English.
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In: Scandinavian Journal of Surgery. - : Sage Publications. - 1457-4969 .- 1799-7267. ; 110:2, s. 222-226
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Abstract
Subject headings
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- BACKGROUND AND AIMS: Esophageal perforations are life threatening. Since the 1990s, placing of covered esophageal stents has become an alternative to surgery. Theoretically, this minimally invasive approach has several benefits; however, little data are available on long-term outcome in these patients. We aimed to evaluate how patient-reported outcome differed between full surgery and placement of self-expanding metallic stents when treating primary benign esophageal perforations.MATERIAL AND METHODS: Of 48 patients treated at our hospital in 2000-2015, 23 were alive and asked to answer three questionnaires. We used a short clinical questionnaire, the QLQ-OG25 from the European Organization for Research and Treatment of Cancer and a simplified quality-of-life instrument, the Check Your Health. Non-parametric statistics were used to evaluate differences between the two groups.RESULTS: In all, 20 (87%) individuals (13 men, 64 years of age) responded. At survey, surgical patients had lost 13 kg of initial weight, compared to no weight loss in the self-expanding metallic stents group (p = 0.01). This involuntary weight loss worried patients according to the QLQ-OG25; otherwise patient-experience measures did not differ between groups. For quality of life, surgical patients scored significantly lower physical health, emotional well-being, social functioning, and overall quality of life after treatment, but after stenting no differences were seen.CONCLUSIONS: In contrast to stenting, surgical treatment was associated with involuntary, and worrisome, weight loss as well as reduced quality of life. We therefore believe that self-expanding metallic stents should be used when possible in treating benign esophageal perforations.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Esophageal perforation
- esophagostomy
- quality of life
- self-expanding metallic stent
- treatment outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
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