Oesophago-gastric resection for cancer is associated with significant post-operative physical and psychological morbidity. Long term results from a high volume centre
AuthorsHouston M, Hanna J, Collins L, Kennedy R, Kennedy A, Clements B, Carey D
Departments / InstitutionsOesophago-Gastric surgery unit, Belfast Trust
Publication DateAutumn 2015
Improving the service cancer sufferers receive and the experience they have requires feedback from those patients. The oesophago-gastric (OG) unit of the Belfast trust is undergoing a service improvement initiative and patient feedback was therefore sought to facilitate this process.
A postal questionnaire was designed by the multidisciplinary team involved in the care and treatment of patients with oesophago-gastric (OG) cancer. Patients that had undergone treatment with curative intent since the formation of OG unit on the BCH site were included. Those with metastatic disease or who had died in the follow-up period were excluded.
The response rate was 46/85 (54%). Mean age of participants was 67.5 years (median 67). Males 32: Female 14. The mean follow-up period was 15.2 months (median 16 months, range 2.5-25). Twenty-two patients had undergone oesophagectomy, 24 gastrectomy. Mean post-operative pain score was 5/10 (median 5, interquartile range 3). Mean score was higher for patients undergoing oesophagectomy (5.6) than gastrectomy (4.6). Almost a third of patients (32%) had a pain score of 7 or greater. Half said they experienced significant pain post-operatively (42% gastrectomy, 55% oesophagectomy. Post discharge there is a significant burden of symptomatology; pain (50% of patients), depression (28%), anxiety (22%), flashbacks (14%) and nightmares (6%).
This study has identified that patients undergoing OG resectional surgery experience pain and anxiety following discharge from hospital. This represents a challenge for clinicians to design interventions that ameliorate such symptoms and support survivorship.