Sleep disturbances and quality of life in postoperative management after esophagectomy for esophageal cancer

Abstract

BackgroundThe aims of this prospective study were to analyze the predictors of postoperative sleep disturbance after esophagectomy for cancer and to identify patients at risk for postoperative hypnotic administration.MethodsSixty two consecutive patients who underwent cancer-related esophagectomy were enrolled in this study from May 2011 to February 2012. Data about perioperative management, postoperative complications, ICU stay, and vasopressor, hypnotic, and painkiller administration were retrieved. The EORTC QLQ-C30 was used and global quality of life (QL2 item) and sleep disturbance (SL item) were the primary endpoints. Univariate and multivariate analyses were performed.ResultsPostoperative request of hypnotics independently predicted bad quality of life outcome. Sleep disturbance after esophagectomy was independently predicted by the duration of dopamine infusion in the ICU and the daily request of benzodiazepines. Even in this case, only sleep disturbance at diagnosis revealed to be an independent predictor of hypnotic administration need. ROC curve analysis showed that sleep disturbance at diagnosis was a good predictor of benzodiazepine request (AUC = 73%, P = 0.02).ConclusionsThe use of vasopressors in the ICU affects sleep in the following postoperative period and the use of hypnotics is neither completely successful nor lacking in possible consequences. Sleep disturbance at diagnosis can successfully predict patients who can develop sleep disturbance during the postoperative period.

The role of trait emotional intelligence in quality of life, anxiety and depression symptoms after surgery for esophageal or gastric cancer: A French national database FREGAT

“…Surgery could minimize the effect of EC on the HRQoL perception of esogastric cancer patients. In fact, surgery and postsurgery complications result in a significant deterioration in their HRQoL . Moreover, this can be reinforced by the fact that patients are not sufficiently informed about the impact of surgery and the long‐term changes in HRQoL .…”

“…Patients with esophageal or gastric cancer are particularly vulnerable because of the poor prognosis and the effects of surgery (eg, fatigue, pain, reflux, dyspnea, dysphagia, eating restrictions). Although surgery is the standard curative treatment, it is among those that most affect quality of life and lead to distress . Surgery tends to cause a major deterioration in patients' health‐related quality of life (HRQoL) with a slow and long recovery .…”

“…Although surgery is the standard curative treatment, it is among those that most affect quality of life and lead to distress . Surgery tends to cause a major deterioration in patients' health‐related quality of life (HRQoL) with a slow and long recovery . Between the presurgery and postsurgery stages, although patients report a stabilization of their anxiety level, they generally experience an increase in their depression symptoms .…”

“…1,2 Surgery tends to cause a major deterioration in patients' health-related quality of life (HRQoL) with a slow and long recovery. 1,[3][4][5][6][7][8] Between the presurgery and postsurgery stages, although patients report a stabilization of their anxiety level, they generally experience an increase in their depression symptoms. 9 However, little is known about the predictors of the postoperative HRQoL and anxiety and depression symptoms of patients with esophageal or gastric cancer.…”

Randomized clinical trial of psychological support and sleep adjuvant measures for postoperative sleep disturbance in patients undergoing oesophagectomy

“…Oesophagectomy also impairs postoperative quality of life (QoL), which is directly related to effective control of pain, and prescription of hypnotics in the early postoperative phase. Control of pain and request for hypnotics could be considered as proxies for severe sleep disturbance. Early postoperative QoL could be improved by enhancing the quality of sleep after oesophagectomy.…”