Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer - A randomized trial
Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer - A randomized trial
复制标题
DOI：
10.1001/jama.287.3.321
复制
发表时间：
2002-01-16
影响因子：
120.7
通讯作者：
Schroeder, G
中科院分区：
文献类型：
--
作者：
Weeks, JC;Nelson, H;Schroeder, G
背景腹腔镜辅助结肠切除术（LAC）已成为结肠疾病首选的微创手术策略。LAC对结肠癌的安全性和有效性尚不清楚，LAC对结肠癌患者的生活质量（QOL）获益的性质和程度也尚不清楚，目的比较LAC与开放性结肠切除术治疗结肠癌后的短期QOL结局。设计、设置和参与者多中心、随机对照试验（手术治疗的临床结局[COST]）。在1994年9月至1999年2月期间，48个中心中的37个中心提供了449例临床可切除结肠癌患者的QOL部分的试验数据，主要结果测量术后2天、2周和2个月的症状困扰量表（SIDS）、生活质量指数和单项总体评定量表评分;结果在449例患者中，428例提供了生活质量数据。在一项比较每个时间点的SDS疼痛强度、SDS总结、QOL指数总结和总体评定量表评分的意向治疗分析中，观察到的组间唯一统计学显著差异是术后2周的总体评定量表评分。术后2周，LAC组的平均（中位数）总体评定量表评分为76.9（80）分，开放性结肠切除术组为74.4（75）分（P= 0.009）。住院期间，与开腹结肠切除术患者相比，LAC组患者需要更少的两种肠外镇痛药天数（平均[中位数]，3.2 [3] vs 4.0 [4]天; P
Context Laparoscopic-assisted colectomy (LAC) has emerged as the preferred minimally invasive surgical strategy for diseases of the colon. The safety and efficacy of LAC for colon cancer are unknown, and the nature and magnitude of any quality-of-life (QOL) benefit resulting from LAC for colon cancer is also unknown.Objective To compare short-term QOL outcomes after LAC vs open colectomy for colon cancer.Design, Setting, and Participants Multicenter, randomized controlled trial (Clinical Outcomes of Surgical Therapy [COST]). Between September 1994 and February 1999, 37 of 48 centers provided data for the QOL component of the trial for 449 consecutive patients with clinically resectable colon cancer.Main Outcome Measures Scores on the Symptoms Distress Scale (SIDS), Quality of Life Index, and a single-item global rating scale at 2 days, 2 weeks, and 2 months postoperative; duration of postoperative in-hospital analgesic use; and length of stay.Results Of 449 patients, 428 provided QOL data. In an intention-to-treat analysis comparing SDS pain intensity, SDS summary, QOL Index summary, and global rating scale scores at each time point, the only statistically significant difference observed between groups was the global rating scale score for 2 weeks postsurgery. The mean (median) global rating scale scores for 2 weeks postsurgery were 76.9 (80) for LAC vs 74.4 (75) for open colectomy (P=.009). While in the hospital, patients assigned to LAC required fewer days of both parenteral analgesics compared with patients assigned to open colectomy (mean [median], 3.2 [3] vs 4.0 [4] days; P