Kvalita života dětí po resekci jater

Quality of Children's Life after Liver Resection

Objective:
The aim was to evaluate the long-term quality of life in children, who were subjected to liver resectionfor malignant or benign disease. Reference to the subjective view of the present state of health was taken in thechildren themselves as well as in their parents.Material: A cohort of children who were subjected to liver resection at author's workplace in the period of1991 - 2002.Methods: Analysis of data of the children operated on and obtained from medical documentation and fromquestionnaires filled in by the living patients or their parents with special emphasis to general health state, qualityof life and morbidity. Moreover, the evaluation of the needs to adhere to dietary measures and to take drugs,evaluation of satisfaction with their health condition, possibilities to perform competition or recreation sports andpossibilities to keep up with common activities of their age match.Results: A total of 56 liver resections were made in children withmalignant or benign diseases in the years 1991- 2002. At the present time 39 patients still live (23 boys and 16 girls). Twenty seven of them were operated on andtreated with chemotherapy for malignant tumors, 12 children underwent liver resection of benign affections(benign tumors, liver injuries, focal nodular hyperplasia, cholangiogenic cysts). The age at the time of operationwas between 0.5 and 14.5 years. The period of observation after the operation was in the range of 1.5 to 13 yearsand the age of the patients is presently 2 - 23 years.The processing of the questionnaires revealed the following results: twenty eight patients (93%) keep up withpersons of the same age, without any long-term medical or limiting difficulties being 24 (80%), feeling satisfactionwith their general health state in 28 (93%) and liver diet keeping seven patients (23%). Drug are regularly takenby four patients (13%) while only one child takes drug for liver disease and 3 other children for other unrelateddiseases. The sickness rate was evaluated as low in 17 children (57%), common in 11 (36%) and frequent in two(7%). The quality of life was evaluated as good in 26 patients (87%), fair in four (13%) and bad in none (0%).Nineteen children practiced recreational or competition sporting activities (63%).Conclusions: Good quality of life, possibility to compete with children of the same age and satisfaction withgeneral health state of their children was reported bymost of the parents. The results of the groups with malignantor benign etiology of the disease were not different.In the long term perspective the liver resection alone does not exert a negative influence on the subsequentquality of life and general health state of the children, being without relation to the extent of resection and age atthe time of operation.

Key words:
resection of liver in children, liver tumors, quality of life