TITLE

QUALITY OF LIFE ASSESSMENT IN PATIENTS UNDERGOING ENDOSCOPIC MUCOSAL ABLATION FOR DYSPLASTIC BARRETT'S OESOPHAGUS

AUTHOR(S)
Ragunath, K.; Krasner, N.; Raman, V.S.; Haqqani, M.T.; Cheung, W.Y.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA42
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: A number of thermal and non-thermal modalities have been applied in an effort to eradicate dysplasia and reverse the Barrett's epithelium. Quality of life (QOL) assessment is an important outcome measure, since these interventions result in procedure related morbidity. Aim: To assess QOL measurement in a cohort of patients with dysplastic Barrett's oesophagus undergoing two different endoscopic mucosal ablation modalities as part of a randomised clinical trial. Methods: Twenty-nine patients with dysplastic Barrett's oesophagus underwent mucosal ablation: Photodynamic therapy (PDT) with Photofrin was performed in one session-13 patients and Argon Plasma Coagulation (APC) was performed in 1-6 (mean 3) sessions-16 patients. Treatment and disease specific QOL questionnaire was constructed based on previous validated Gastrointestinal QOL tool. A 10-item questionnaire was constructed with 5 responses in each question. Most desirable option: 5 points, and least desirable option: 1 point (maximum: 50, minimum: 10). Patients were asked to fill the questionnaire immediately before the procedure and 2 weeks after the procedure (in the case of APC after the first session). The scores before and after treatment were compared using the paired t test and the difference between the two treatment groups was analysed using the unpaired t test. Results: All but 3 patients in the APC group completed the study. In the PDT group the mean pre-treatment QOL score was 45 and post treatment QOL score was 39, p=0.0002 (95% CI 3.54-8.76). In the APC group the mean pre-treatment score was 39 and post-treatment score was 33, p=0.0008 (95% CI 2.80-8.27). There was no significant difference in QOL pre and post-treatment between the two groups. Conclusion: QOL is significantly affected in patients undergoing endoscopic mucosal ablation therapy for at least 2 weeks following the procedure. Future studies comparing various endoscopic mucosal ablation modalities should assess QOL as...
ACCESSION #
9747550

 

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