Pancreatic Enzyme Supplementation Improves Quality of Life in Patients Following Surgery for Upper GI Cancer

Q4 Medicine

Surgery, Gastroenterology and Oncology Pub Date : 2021-06-30 DOI:10.21614/sgo-26-2-322

C. Alexander, R. Kay, Sajid Waheed Rahman, C. Deans

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引用次数: 0

Abstract

Background: Unpleasant abdominal symptoms are common following surgery for upper gastrointestinal (UGI) cancer and may occur secondary to pancreatic exocrine insufficiency (EPI). This study investigated symptoms of EPI in patients following surgery and assessed the effect of pancreatic enzyme supplementation (PERT) on these symptoms and the effect of supplementation on quality of life. Methods: Patients were assessed for symptoms of EPI using a novel questionnaire. Patients who reported two or more symptoms suggestive of EPI were prescribed PERT. Abdominal symptoms were reassessed following treatment. Quality of life (QoL) was studied using the SF-36 questionnaire before and after treatment. Faecal elastase was measured in a patient subgroup. Results: Fifty-six out of 57 patients (98%) reported at least two symptoms of EPI. Following PERT every patient reported fewer abdominal symptoms; median 5 symptoms before treatment reduced to two symptoms following treatment (p<0.0001; Wilcoxon rank). Reduced faecal elastase concentration was associated with more frequent abdominal symptoms; median 5 symptoms versus 3 symptoms (p = 0.043; Mann Whitney U test). PERT increased quality of life scores for every patient in each of the 5 principle health domains. Conclusion: Symptoms of EPI are common among patients following UGI cancer surgery. PERT reduces unpleasant abdominal symptoms and this leads to significant improvements in quality of life across global health domains. PERT should be offered to all post-operative UGI cancer patients with symptoms suggestive of EPI.

查看原文本刊更多论文

胰酶补充改善上消化道肿瘤手术后患者的生活质量

背景:不愉快的腹部症状是上胃肠道(UGI)癌手术后常见的症状，可能继发于胰腺外分泌功能不全(EPI)。本研究调查了手术后EPI患者的症状，并评估了胰酶补充(PERT)对这些症状的影响以及补充对生活质量的影响。方法:采用一种新颖的问卷对EPI患者的症状进行评估。报告两种或两种以上提示EPI症状的患者开PERT。治疗后重新评估腹部症状。采用SF-36问卷对治疗前后患者的生活质量(QoL)进行研究。在患者亚组中测量粪便弹性蛋白酶。结果:57例患者中有56例(98%)报告了至少两种EPI症状。采用PERT后，每位患者报告的腹部症状较少;治疗前中位症状5个，治疗后中位症状2个(p<0.0001;Wilcoxon排名)。粪便弹性酶浓度降低与更频繁的腹部症状相关;中位5种症状vs . 3种症状(p = 0.043;曼·惠特尼测试)。PERT提高了5个主要健康领域中每个患者的生活质量评分。结论:EPI症状在UGI肿瘤手术后患者中很常见。PERT可减少不愉快的腹部症状，从而显著改善全球卫生领域的生活质量。所有术后有EPI症状的UGI癌症患者应提供PERT。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery, Gastroenterology and Oncology Medicine-Gastroenterology

CiteScore

0.30

自引率

0.00%

发文量

期刊介绍： Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.