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Long-Term Quality of Life Assessment After Successful Endoscopic Vacuum Therapy of Defects in the Upper Gastrointestinal Tract Quality of Life After EVT

Journal of Gastrointestinal Surgery volume 23, pages 280–287 (2019)Cite this article

Abstract

Background

Accumulating evidence indicates that anastomotic leakages and perforations of the upper gastrointestinal tract (uGIT) can be treated successfully with endoscopic vacuum therapy (EVT). So far, no data is available regarding the long-term quality of life (QoL) after successful EVT of defects in the uGIT.

Methods

We present a prospective survey on long-term Qol of 52 patients treated by EVT for defects of the uGIT. Results are compared with 63 of 221 patients treated by esophagectomy without anastomotic insufficiency (w/o EVT) between 12/2011 and 12/2015. The Gastrointestinal Quality of Life-Index (GIQLI) score was determined by a 36-item questionnaire of 25 respondents with EVT and 50 respondents w/o EVT.

Results

The response rate was 78.95% (75/95) including 25 survey respondents who were treated with EVT for anastomotic insufficiency secondary to esophagectomy or gastrectomy (n = 19), iatrogenic esophageal perforation (n = 4), and Boerhaave syndrome (n = 2) and 50 respondents with complication-free esophagectomy w/o EVT. The median follow-up was 19 months for EVT patients and 21 months for patients w/o EVT. Except for “social function” (p = 0.009) in favor for patients w/o EVT, the median GIQLI score did not differ significantly between both study groups concerning the categories ‘symptoms’, ‘emotions’, ‘physical functions’, and ‘medical treatment’ resulting in a total median GIQLI score of 83 in EVT versus 96.5 in patients w/o EVT (p = 0.185). Spearman Rho analysis revealed that a high GIQLI score correlated with a low ASA score (p < 0.001), a benign pathology (p = 0.001), and a hospital stay less than 21 days (p < 0.001).

Conclusion

EVT in the uGIT is well tolerated by the patients and accompanied by a satisfactory long-term QoL.

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Abbreviations

BMI:

Body mass index

EVT:

Endoscopic vacuum therapy

GI:

Gastrointestinal

GIQLI:

Gastrointestinal Quality of Life Index

r:

Spearman’s rank correlation coefficient

w/o EVT:

Without endoscopic vacuum therapy

QoL:

Quality of life

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Acknowledgements

The authors thank our study secretary Ms. Ulrike Thoben for her support and expert technical assistance.

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Affiliations

  1. Department of General and Visceral Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Bldg. W1, 48149, Muenster, Germany

    Sameer A. Dhayat, Rosanna Schacht, Rudolf Mennigen, Daniel Palmes, Thomas Vogel, Thorsten Vowinkel, Norbert Senninger & Mike Georg Laukoetter

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  1. Sameer A. Dhayat
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  2. Rosanna Schacht
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  3. Rudolf Mennigen
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  8. Mike Georg Laukoetter
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Contributions

SAD and MGL designed the study. All authors contributed substantially to the conception and acquisition of the study. All authors collected all data and SAD, RS, and MGL analyzed all data. Further, all authors performed critical revision for important intellectual content and gave final approval of the version to be published. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Mike Georg Laukoetter.

Ethics declarations

Ethical approval for postoperative QoL survey was obtained (Ethics committee, University Muenster, Az: 2016-687-f-S) and all patients provided written informed consent.

This analysis was approved by the local institutional review board and was performed in accordance with the Helsinki Declaration of 1975, as revised in 1983.

Conflict of Interests

M.G. Laukoetter is a member of the expert panel of negative pressure wound therapy of the Paul Hartmann (AG) holding company. He received fees for invited speeches on endoscopic vacuum therapy. All other authors declare that they have no conflicts of interest or financial ties to disclose.

Electronic supplementary material

Supplementary table 1

Gastrointestinal Quality of Life Index item scores of patients with endoscopic vacuum therapy (EVT) vs. without endoscopic vacuum therapy (w/o EVT). (DOCX 16 kb)

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Dhayat, S.A., Schacht, R., Mennigen, R. et al. Long-Term Quality of Life Assessment After Successful Endoscopic Vacuum Therapy of Defects in the Upper Gastrointestinal Tract Quality of Life After EVT. J Gastrointest Surg 23, 280–287 (2019). https://doi.org/10.1007/s11605-018-4038-9

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  • DOI: https://doi.org/10.1007/s11605-018-4038-9

Keywords

  • Negative-pressure wound therapy
  • Upper gastrointestinal tract
  • Anastomotic leakage
  • Quality of life