Prehabilitation for gastrointestinal cancer patients / 中华胃肠外科杂志

Gastrointestinal cancer and related treatments (surgery and chemoradiotherapy) are associated with declined functional status (FS) that has impact on quality of life, clinical outcome and continuum of care. Psychological distress drives an impressive burden of physiological and psychiatric conditions in oncologic care. Cancer patients often experience anxiety, depression, low self-esteem and fears of recurrence and death. Cancer prehabilitation is a process from cancer diagnosis to the beginning of treatment, which includes psychological, physical and nutritional assessments for a baseline functional level, identification of comorbidity, and targeted interventions that improve patient's health and functional capacity to reduce the incidence and the severity of current and future impairments with cancer, chemoradiotherapy and surgery. Multimodal prehabilitation program encompasses a series of planned, structured, repeatable and purposive interventions including comprehensive physical exercise, nutritional therapy, and relieving anxiety and depression, which integrates into best perioperative management ERAS pathway and aims at using the preoperative period to prevent or attenuate the surgery-related functional decline, to cope with surgical stress and to improve the consequences. However, a number of questions remain in regards to prehabilitation in gastrointestinal cancer surgery, which consists of the optimal makeup of training programs, the timing and approach of the intervention, how to improve compliance, how to measure functional capacity, and how to make cost-effective analysis. Therefore, more high-level evidence-based studies are expected to evaluate the value of implementation of prehabilitation into standard practice.

Adaptación transcultural del cuestionario de calidad de vida gastrointestinal GIQLI (Gastrointestinal Quality of Life Index) para su aplicación en pacientes operados del aparato gastrointestinal / Transcultural adaptation of the GIQLI questionnaire (Gastrointestinal Quality of Life Index) in patients operated from the gastrointestinal system

INTRODUCCIÓN: La escala GIQLI sobre calidad de vida gastrointestinal es ampliamente usada por gastroenterólogos y cirujanos digestivos. Hace falta su adaptación transcultural para su aplicación local. OBJETIVOS: Realizar una adaptación transcultural de la versión en español neutro del cuestionario GIQLI sobre calidad de vida gastrointestinal, efectuando traducción, comparación de traducciones, traducción inversa y prueba piloto. RESULTADOS: La población logró comprender parcialmente el instrumento, los ítems confusos se modificaron creando una versión provisoria, se volvió a aplicar el cuestionario modificado en plan piloto con comprensión satisfactoria. CONCLUSIONES: Se cuenta con una versión adaptada del cuestionario GIQLI para ser usado en Chile, la cual puede someterse a procesos de validación en población local para ser usada en pacientes operados del aparato gastrointestinal.

BACKGROUND: GIQLI of gastrointestinal quality of life is widely used by gastroenterologists and digestive surgeons. Its transcultural adaptation is needed for its local application. AIM: To carry out a transcultural adaptation of the neutral English version of GIQLI, carrying out translation, comparison of translations, reverse translation and pilot test. RESULTS: The population partially understand the instrument, the confusing elements were modified creating a provisional version, and the provisory version was applied again in a pilot research, with satisfactory understanding. CONCLUSIONS: There is an adapted version of the GIQLI to be used in Chile, which can be subjected to validation processes in local population to be used in patients operated on in the gastrointestinal tract.

Calidad de vida relacionada con salud: instrumentos de medición para valoración de resultados en cirugía digestiva alta / Health-related quality of life. Measurement tools to assessing upper gastrointestinal surgery outcomes

Background: Since a while, clinicians and surgeons recently have recognized the desirability of Health-related quality of life (HRQOL) measure to inform their patients, even health authorities in respect of decision making in health and as a variable to be considered in clinical research. For this, there are multiple questionnaires (including self-administered) that are available for measuring this construct. In the field of upper gastrointestinal surgery, there are tools that have been generated and validated for this purpose (some of them generals and other specifics). The aim of this article is to describe specific measurement instruments to assess HRQOL in upper gastrointestinal surgery. Material and Methods: A search on engines Altavista, Google and Yahoo, in Ixquick and Copérnico metasearch and in the database "Documents in Information Science" (DoIS) was performed. The search strategy used the terms "Quality of Life", "Health-related quality of life", "HRQOL", "Outcome Assessment (Health Care)", "upper gastrointestinal surgery" and "digestive surgery". After locating articles, these were evaluated and a summary document of collected information was developed. Results: The search performed gave 23 instruments: related with upper gastrointestinal benign disease (10), with obesity and bariatric surgery (4), and related with digestive neoplasms (9). Conclusion: There is an interesting variety of instruments to measure HRQOL in upper gastrointestinal surgery. Knowing is a user support to both the development of everyday surgical practice, as for decision-making in health and as measurement instruments in clinical research.

Antecedentes: Desde hace un tiempo a esta parte, los clínicos y últimamente los cirujanos han reconocido la conveniencia de medir la calidad de vida relacionada con salud (CVRS) para informar a sus pacientes y a las autoridades sanitarias respecto de la toma de decisiones en salud y como variable a considerar en investigación clínica. Para ello, existen múltiples cuestionarios (incluso auto-administrados) que se encuentran disponibles para medir este constructo. En el ámbito de la cirugía digestiva alta, existen instrumentos que se han generado y validado con este propósito (algunos generales y otros de carácter específico). El objetivo de este artículo es describir instrumentos de medición específicos para valorar CVRS en cirugía digestiva alta. Material y Método: Se realizó una búsqueda en los motores Google y Yahoo; en los metabuscadores Ixquick y Copérnico; y en la base de datos "Documents in Information Science" (DoIS). En la estrategia de búsqueda, se utilizaron los términos "calidad de vida", "calidad de vida relacionada con salud", "CVRS", "cirugía digestiva alta" y "cirugía gastrointestinal". Una vez localizados los resúmenes de los artículos localizados, se evaluaron los documentos en extenso y se desarrolló un documento resumen de la información recolectada. Resultados: La búsqueda realizada arrojó un total de 23 instrumentos; algunos relacionados con enfermedades benignas del tubo digestivo alto (10), otros relacionados con obesidad y cirugía bariátrica (4); y otros concernientes a cáncer del tubo digestivo alto (9). Conclusión: Existe una variedad interesante de instrumentos para medir CVRS en cirugía digestiva alta. Conocerlos constituye una ayuda al usuario tanto para el desarrollo de su práctica quirúrgica cotidiana, la toma de decisiones en salud y como instrumentos de medición en investigación clínica.