Baghavath, Ponkailasam Rajam (2016) A study on improvement of quality of life after esophageal stenting in carcinoma of esophagus. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
The main aim of palliation in patients with inoperable esophageal cancer is to relieve dysphagia with acceptable morbidity and mortality, and thus improve quality of life (QOL). The use of a self-expanding metal stent (SEMS) is a well established modality for palliation of dysphagia in such patients. In our study assessed the QOL after palliative stenting in patients with inoperable esophageal cancer. Twenty one patients with dysphagia due to inoperable esophageal cancer underwent SEMS insertion between september 2014 and September 2015 in Coimbatore Medical College Hospital. All patients had grade III/IV dysphagia (n=21), In our study the procedural success rate was around 95% out of 21 patients only one patient had the complication of stent migration, which needed reinsertion. In our study, the relief of dysphagia, general health related improvement of quality of life, and pain related improvement of quality of life were studied with the help of EORTC QLQ 30 OES 18 questionnaire, in addition to this we have studied and compared the anthropometric improvement like BMI, Biochemical improvement like, Hemoglobin ,Total proteins ,and other liver function tests, SGOT, SGPT, before and after stenting. The dysphagia score is 6.10+1.48 before stenting ,it improved to 12.57+2.29 after 1 week,15.05+1.74,after 4 weeks and 15.57 +1.20 after 8 weeks. Thus the improvement of dysphagia before and after stenting is statistically significant. The personal social health related quality of life score before stenting was 32.95+2.24, it improved to 26.33+3.56, after one week ,15.05 +2.22 after 4 weeks and 13.14+1.98 after 8 weeks. The improvement of health related quality of life is also statistically significant. The pain related quality of life was 7.10+1.54 before stenting, after one week the pain got worsened and it increased to 10.00+1.97. The worsening of pain after one week is statistically significant .After 4 weeks the pain related quality of life improved from the baseline score before stenting to 5.38,and after 8 weeks it further improved to 4.00+0.95,These improvements in pain related quality of life too are statistically significant. The improvement of BMI and Hemoglobin 4 weeks after stenting is statistically not significant , but 8 weeks after stenting, the improvement of BMI and hemoglobin are statistically significant The biochemical parameters like Blood sugar, Urea are within the normal limits except for the diabetic patients, but the variation is statistically significant , before Vs 4 weeks and 8 weeks after stenting. The variation in the creatinine values before and after stenting is not significant. A statistically significant improvement is noted in the values of the total proteins and albumin measured at 4 weeks and 8 weeks post stenting, whereas the globulin improvement became significant only after 8 weeks. No statistically significant changes are noted in the values of liver function tests like total bilirubin and SGOT, but SGPT values are found to be increased with statistically significant values, 8 weeks after stenting.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Esophageal stenting ; SEMS ; Quality of life after stenting ; carcinoma of esophagus. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 27 Sep 2017 03:10 |
| Last Modified: | 27 Sep 2017 03:10 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3387 |
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