TY - JOUR
T1 - Laparoscopic-assisted versus open pancreaticoduodenectomy
T2 - Early favorable physical quality-of-life measures
AU - Langan, Russell C.
AU - Graham, Jay A.
AU - Chin, Anne B.
AU - Rubinstein, Aaron J.
AU - Oza, Kesha
AU - Nusbaum, Jeff A.
AU - Smirniotopoulos, John
AU - Kayser, Reilly
AU - Jha, Reena
AU - Haddad, Nadim
AU - Al-Kawas, Firas
AU - Carroll, John
AU - Hanna, Jane
AU - Parker, Ann
AU - Al-Refaie, Waddah B.
AU - Johnson, Lynt B.
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/8
Y1 - 2014/8
N2 - Background We compared outcomes and postpancreatectomy quality of life (QOL) in paired cohorts of patients undergoing conventional open pancreaticoduodenectomy (OPD) or laparoscopic-assisted pancreaticoduodenectomy (LAPD). Methods Comparative analysis of QOL was performed in a matched cohort of 53 patients after OPD or LAPD between 2010 and 2013. The Medical Outcomes Study Short Form-36 Health Survey and the Karnofsky score were used. Results Physical component score, mental component score, and Karnofsky scores were calculated at multiple time points for OPD (n = 25) and LAPD (n = 28). Operative times, complications, and readmission rates were equivalent. Time to starting adjuvant therapy trended toward clinical importance in LAPD (61 vs 110 days, P =.0878). Duration of stay was less in LAPD (7.10 vs 9.44 days, P =.02). LAPD had a superior QOL centered on functional status compared with OPD (physical component score 49.09 vs 38.4, P =.04; Karnofsky 92.22 vs 66.92%, P =.003). These statistical differences were not observed beyond 6 months. Conclusion LAPD provided a more favorable QOL within the first 6 months and shorter length of stay compared with conventional OPD. LAPD may serve as an alternative operative therapy to potentially minimize delays in receipt of and enhance tolerability of adjuvant therapies.
AB - Background We compared outcomes and postpancreatectomy quality of life (QOL) in paired cohorts of patients undergoing conventional open pancreaticoduodenectomy (OPD) or laparoscopic-assisted pancreaticoduodenectomy (LAPD). Methods Comparative analysis of QOL was performed in a matched cohort of 53 patients after OPD or LAPD between 2010 and 2013. The Medical Outcomes Study Short Form-36 Health Survey and the Karnofsky score were used. Results Physical component score, mental component score, and Karnofsky scores were calculated at multiple time points for OPD (n = 25) and LAPD (n = 28). Operative times, complications, and readmission rates were equivalent. Time to starting adjuvant therapy trended toward clinical importance in LAPD (61 vs 110 days, P =.0878). Duration of stay was less in LAPD (7.10 vs 9.44 days, P =.02). LAPD had a superior QOL centered on functional status compared with OPD (physical component score 49.09 vs 38.4, P =.04; Karnofsky 92.22 vs 66.92%, P =.003). These statistical differences were not observed beyond 6 months. Conclusion LAPD provided a more favorable QOL within the first 6 months and shorter length of stay compared with conventional OPD. LAPD may serve as an alternative operative therapy to potentially minimize delays in receipt of and enhance tolerability of adjuvant therapies.
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U2 - 10.1016/j.surg.2014.03.018
DO - 10.1016/j.surg.2014.03.018
M3 - Article
C2 - 24680859
AN - SCOPUS:84904268507
SN - 0039-6060
VL - 156
SP - 379
EP - 384
JO - Surgery (United States)
JF - Surgery (United States)
IS - 2
ER -