Physical Function and Quality of Life after Thoracoabdominal Oesophageal Resection

Abstract

Background: The long-term functional outcome after thoracoabdominal resection has to be better evaluated. A study was performed to evaluate patients after a similar operation both in terms of physical function and health-related quality of life (HRQL). Methods: Eighteen patients were evaluated 2 years after a thoracoabdominal resection. Respiratory function, physical performance and range of motion in shoulder, thorax and spine were recorded. HQRL was assessed by EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30) and EORTC QLQ-OES18 (Oeophageal module). Results: Two years after surgery, respiratory function (forced vital capacity and forced expiratory volume in 1 s) was significantly impaired compared to preoperative values (p < 0.05). The physical performance was significantly reduced as measured by a functional stand-up test (p < 0.05) and the handgrip force (p < 0.001). Shoulder range of motion, thoracic lateral flexion and C7 to wall were within normal ranges, thoracic flexion significantly greater (p < 0.01) but chest expansion significantly decreased (p < 0.01) compared to controls. HQRL was comparable to age- and sex-matched population norms for most of the functions. A clinical significant difference was, however, found for diarrhoea, dyspnoea, appetite loss and fatigue. Conclusion: Within a 2-year period, each individual regains most of the respiratory and physical performances and HRQL after a thoracoabdominal resection.

Changes in motor function and quality of life after surgery in patients with pancreatic cancer

“…Previous studies revealed that surgery is associated with decreased motor function in patients with oesophageal and colorectal cancers (Fagevik Olsén et al, 2005; Inoue et al, 2016; Sánchez‐Jiménez et al, 2015; Tatematsu et al, 2013). Therefore, given that surgery for pancreatic cancer is more invasive than that for colorectal cancer, motor function is also expected to decrease after pancreatectomy.…”

Procedure-related chronic pain after thoracoabdominal resection of the esophagus

“…It is of interest that both shoulders were equally affected. The explanation behind the high proportion of patients with pain in the left shoulder may be that, postoperatively, some patients increase their thoracic kyphosis (Fagevik Olse´n, Larsson, Hammerlid, and Lundell, 2005) with protruding shoulders, which may lead to impingement pain.…”

“…In 2005, a 2-year follow-up of the physical and functional status of 18 patients after thoracoabdominal esophageal resection found that they had a significantly reduced respiratory function compared to their preoperative status and that chest expansion was significantly impaired compared to age-and sex-matched controls (Fagevik Olse´n, Larsson, Hammerlid, and Lundell, 2005). A possible reason for this restrictive pattern may be the surgical trauma and persistent postoperative pain.…”

Quality of Life during Neoadjuvant Therapy for Patients with Esophageal Cancer

“…These same authors concluded that because of the good sensitivity and specificity of the questionnaires, it was possible to detect small benefits associated with various forms of treatment [12]. In addition to this publication, other studies have also shown that the combined use of QLQ-C30 and QLQ-OES18 objectively reflects QoL in patients with esophageal cancer, which has been shown to be fundamental to ensure replicable results and to allow comparison between different populations [13][14][15][16][17][18].…”