Assessment of quality of life in patients with non-operated pancreatic cancer after videothoracoscopic splanchnicectomy

Introduction: Pancreatic tumours are a crucial medical issue. The majority of patients report sick in the late stage ofcarcinoma clinical advancement, which considerably limits the possibility of surgical treatment. Pancreatic cancerpatients with no other alternative but palliative treatment constitute a large group.Aim: To assess pain intensity levels and quality of life of pancreatic cancer patients after videothoracoscopic splanchnicectomy.Material and methods: Between 2001 January and 2010 November in the Department of Thorax, General Surgery andOncology of the Medical University of Lodz 262 patients with pancreatic tumours were hospitalized. In 121 casesgrade 3 and grade 4 tumours were observed. Hundred and twenty-one videothoracoscopic procedures of sympathetictrunk and ganglion excision were performed in 89 patients.Results: Before the procedure the pain intensity level according to VAS was 5.66 (3.9-7.2; SD 1.24) in the trial groupand 5.46 (4.1-7.1; SD 1.15) in the control group. The quality of life average assessment in both groups did not differ statistically(p = 1.07) and was 46.3 (32-66; SD 0.92) in patients before the operation and in the control group 50.3(41-63; SD 0.75). On the 7th postoperative day the pain intensity on average was 2.33 (1.2-3.9; SD 0.78) and 4.57(3.6-5.5; SD 0.69) respectively. One week after the procedure the quality of patients’ life was estimated at 64.1(39-83; SD 1.38) and in the control group at 52.2 (42-65; SD 0.71); the differences are significant (p < 0.05). Thirty daysafter the procedure 12 patients did not t ake any painkillers (13.5%), and in the others a considerable decrease of thetaken drugs was observed. On average, the pain intensity was estimated at 1.78 (0.6-3.6; SD 0.68). The quality of life,on the other hand, improved considerably in relation to the state prior to the procedure, but increased insignificantlyin relation to the state on the 7th postoperative day to 70.9 (52-88; SD 1.14).Conclusions: Splanchnicectomy is a safe method of cancer pain treatment in patients with advanced pancreatictumours. Videothoracoscopic excision of visceral nerve thoracic section contributes to the statistically significantdecrease of cancer pain intensity and considerably improves the quality of patients’ lives.