Impact of jejunostomy during esophagectomy for cancer on health related quality of life

Background： The aim of this study was to evaluate the impact of jejunostomy during esophagectomy for cancer on postoperative health-related quality of life（HRQL）.Methods： We evaluate all consecutive patients who underwent esophagectomy for cancer at the surgical oncology unit of the Veneto Institute of Oncology（IOV-IRCCS） between January 2008 and March 2014. The primary outcome was HRQL, which was assessed using nine scales of EORTC C30 and OES18 questionnaires. General linear models were estimated to evaluate mean score difference（MD） of each selected scale in patients with and without jejunostomy, adjusting for clinically relevant confounders. The secondary outcomes were morbidity, hospital stay, postoperative weight loss and postoperative albumin impairment. Results： Jejunostomy was performed in 40 on 109 patients（41.3%） who participated in quality of life investigation. A clinically and statistically significantly worse eating at admission（P=0.009） became not clinically significant at 3 months after surgery（MD =9.1）. Jejunostomy was associated to clinically and statistically significantly poorer emotional function（EF） at 3 months after surgery（MD =-15.6; P=0.04）. Hospital stay was longer in jejunostomy group（median, 20 vs. 17 days, P=0.02）.Conclusions： In our series patients who had a jejunostomy during esophagectomy had been selected for their risk for postoperative complication. However, their postoperative outcome was actually similar compared to those without jejunostomy. Nevertheless, jejunostomy was associated to clinically and statistically significantly poorer EF at 3 months after surgery. Therefore, patient candidate to esophagectomy and feeding jejunostomy should receive additional psychological support.

儿童急性淋巴细胞白血病长期化疗后生存质量评估

目的:评估儿童急性淋巴细胞白血病(acute lymphocytic leukemia,ALL)经长期化疗后与健康相关的生存质量(health-re-lated quality of life,HRQL),并分析影响其部分的相关因素。方法:分析2013年1月至2019年6月在南通大学附属医院确诊为ALL的108例患儿临床资料,按照中国儿童白血病协作组(Chinese Children Leukemia Group,CCLG)-ALL-2008或中国儿童癌症协作组(Chinese Children Cancer Group,CCCG)-ALL-2015方案按序规范治疗,后随诊于南通大学附属医院。以健康儿童和同胞为双对照组,通过自设调查表和中文版儿童生存质量普适性核心量表(PedsQL 4.0)对ALL患儿进行调查分析。结果:ALL患儿的生存质量评分低于健康儿童组和同胞组,呈显著性差异(P<0.05)。患儿性格类型、家庭教育方式、填表时年龄、结束化疗后时间、确诊时危险分级为相关因素。结论:ALL患儿HRQL低于健康儿童组和同胞组,影响因素包括临床和社会学方面,应尽早筛查目标人群,针对性采取措施,提高其生存质量。