The authors report on the effectiveness of videothoracoscopic splanchnicectomy (VSPL) as a method of pain treatment in patients with chronic pancreatitis (CP). A minimally invasive technique, VSPL is used in CP as an alternative method of pain treatment. The aim of the investigation was to evaluate by a prospective, semirandomized case-control study the influence of VSPL on the quality of life and the level of pain suffered by patients with CP. The study groups consisted of 32 patients who underwent VSPL between March 2000 and January 2001 and a control group of 32 CP patients who received conservative treatment. The effect of the therapy on subjective pain measures and multiparametric quality of life was measured before VSPL and throughout the first year thereafter. In the follow-up period there was a significant decrease in intensity of pain and an improvement in the quality of life of the patients-most significantly concerning emotional well-being and functioning in everyday life. We conclude that the VSPL is a safe, effective, and minimally invasive procedure and recommend that it be used in such cases.
Zusammenfassung Hintergrund: Ziel der vorliegenden Untersuchung war es, die Wirksamkeit der videothorakoskopischen Splanchnikektomie (VSPL) bei der Schmerztherapie von Patienten mit chronischer Pankreatitis und Pankreaskarzinom darzustellen. Die VSPL stellt eine minimal invasive Methode dar, die bei diesen Patienten als Alternative zu anderen Verfahren der Schmerzbehandlung eingesetzt werden kann. Patienten und Methodik: Die Untersuchung wurde an 34 Patienten durchgeführt, die sich zwischen März 2000 und März 2001 einer VSPL unterzogen. Die Daten wurden prospektiv erhoben, der Einfluss der VSPL auf die Lebensqualität und das Schmerzniveau bei Patienten mit chronischer Pankreatitis und inoperablem Pankreaskarzinom wurde 1, 3, 6 und 12 Monate pOp überprüft. Ergebnisse: Im Nachbeobachtungszeitraum kam es zu einer signifikanten Abnahme des Schmerzniveaus und einem Anstieg der Lebensqualität der Patienten. Dies betraf vor allem das emotionale Wohlbefinden und die Verrichtungen des täglichen Lebens. Folgerung: Wir schlieûen aus dieser Untersuchung, dass die videothorakoskopische Splanchnikektomie eine sichere, minimal invasive Methode darstellt, die für Patienten mit chronischer Pankreatitis und inoperablem Pankreaskarzinom empfohlen werden kann. SchlüsselwörterVideothorakoskopische Splanchnikektomie´chronische Pan-kreatitis´Pankreaskarzinom Abstract Background: The paper presents the effectiveness of videothoracoscopic splanchnicectomy (VSPL) as a method of pain treatment in patients with chronic pancreatitis or pancreatic cancer. VSPL is a minimally invasive technique used in chronic pancreatitis or pancreatic cancer patients as an alternative to other procedures of pain treatment. Study design: The aim of the study was to evaluate by prospective, non-randomised assay the influence of VSPL on the quality of life and the level of pain in patients with chronic pancreatitis and inoperable pancreatic cancer. The material consisted of thirty four patients that underwent VSPL between March 2000 and March 2001. The effect of the therapy on subjective pain measures and multiparametric quality of life was measured before the VSPL and throughout one, three, six and twelve months after it. Results: In the period covered by the follow-up there was a significant decreased intensity of pain and an elevation of quality of life of the patients ± most significantly concerning emotional well-being and functioning in every-day life. Conclusion: We conclude that videothoracoscopic splanchnicectomy is a safe and minimally invasive procedure which is advisable in patients with chronic pancreatitis and inoperable pancreatic cancer.
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