The British journal of surgery
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Quality of life following resection of oesophageal carcinoma was assessed by patients using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and by a psychologist using the Spitzer Index. Quality of life was evaluated in 119 patients on one occasion 12 months after operation and in 30 patients regularly, starting with a preoperative assessment. Self and external evaluation showed a significant correlation (r = 0.61), but quality of life was assessed as being higher by the external observer. ⋯ Of several factors analysed only tumour recurrence (P < 0.01) and anastomotic stricture (P < 0.05) lowered quality of life significantly. Compared with the preoperative assessment, quality of life had decreased on discharge from hospital but was restored within 6 months of operation in disease-free patients. Further studies are required to determine the impact of adjuvant therapy for quality of life in patients undergoing surgery for oesophageal cancer.
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Despite improved surgical techniques there is still a risk of mortality in elective general surgery. In a prospective study preoperative data from 3250 patients were collected and compared with postoperative systemic complications, using univariate chi 2 analysis. Highly significant (P < 0.00001) variables were subjected to stepwise logistic regression analysis. ⋯ Using these four variables, a simple preoperative risk scoring system has been defined. Class A (up to 5 points) was defined as a low-risk group (systemic complication rate 5.0 per cent), class B (5-7 points) was intermediate risk (systemic complication rate 17.9 per cent) and class C (8-10 points) was high risk (systemic complication rate 33.3 per cent). Patients at high risk for perioperative and postoperative complications are more likely to be identified by this analysis than by using the ASA classification alone.