Impact of the method of reconstruction after oncologic oesophagectomy on quality of life — a prospective, randomised study

OBJECTIVE: For patients undergoing oncologic surgery, the quality of life (QoL) is generally accepted as an important outcome parameter in addition to long-term survival, mortality and complication rates. This study focussed on the QoL in patients after oesophagectomy for cancer, comparing the method of reconstruction (narrow gastric tube vs whole stomach). METHODS: In a prospective randomised single-centre study from 2007 to 2008, 104 patients underwent oesophagectomy for cancer. To assess the QoL, a questionnaire in reference to the EORTC-QLQ-C30 and the QLQ-OES24 was administered at 3 weeks, 6 months and 1 year after surgery. Clinical data were collected prospectively, and follow-up was performed regularly. RESULTS: There were no significant differences between the narrow gastric tube group (NGT group, n=52) and the whole-stomach group (WS group, n=52) with regard to patient and cancer characteristics, operative procedure, postoperative intensive care unit (ICU) hospitalisation, and overall survival at 1 year. Regarding the postoperative complication, there were more cases of postoperative reflux oesophagitis and impairment of pulmonary function in the WS group (P<0.05). Regarding the QoL investigation, the scores of QoL dropped for all patients at 3 weeks after surgery. Slowly, recovery was found at both 6 months and 1 year in both groups. Patients in the NGT group reported significantly (P<0.05) better scores of QoL at both 6 months and 1 year. CONCLUSIONS: Patients who underwent gastric tube reconstruction develop less postoperative digestive tract complications, and have a quicker recovery and a better QoL during the follow-up period. Further investigation and data collection will allow the assessment of this procedure beyond 1 year after operation.