Qualidade de vida pós-cirurgica e resultados no tratamento da acalásia

Abstract

Objectives: Evaluate the Quality of Life in patients diagnosed with achalasia who performed Heller's myotomy. Methods: Between 1st January 2000 and 27th March 2019, 99 patients were submitted to oesophagomyotomy at the São João Hospital in Oporto, Portugal. The exclusion criteria were: other diagnoses, age below 18 years old at the date of surgery and death. 75 patients were contacted. Preoperative and postoperative evaluations were performed using the Achalasia disease-specific Quality of Life questionnaire developed by Urbach et. al. and by the Eckardt score. Quality of Life was assessed by the Medical Outcomes Study SF-36. Results: 49 patients (65%) answered the questionnaires. The median difference in the Achalasia disease-specific Quality of Life questionnaire between the pre-operative and postoperative period was -9.0 (IQR: 5-12), while in the Eckardt score was -5.0 (IQR: 3.25-7). Lower postoperative scores correlated with higher scores on the SF-36's mental and physical summary measures (ρ=-0.651 and ρ=-0.577 for the Achalasia disease-specific Quality of Life questionnaire and ρ=-0.552 and ρ=-0.515 for the Eckardt score, P<0.001). Physical and mental summary measures were correlated with each other (ρ=0.788, P<0.001). Conclusions: Heller's myotomy allows a decrease in symptoms and an increase in Quality of Life. Patients with severe symptoms before surgery had higher postoperative scores and patients with fewer symptoms had lower postoperative scores, suggesting that early intervention provides better outcomes in Quality of Life.