Division of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Dis Esophagus. 2010 Jul;23(5):408-14. doi: 10.1111/j.1442-2050.2009.01025.x. Epub 2009 Nov 23.
For patients with esophageal cancer, radical surgical resection of the esophagus and surrounding lymph nodes is the only curative treatment option. The conventional open esophagectomy has the disadvantage of extensive trauma and slow recovery. Recently, video-assisted thoracoscopic surgery (VATS) has been applied in esophagectomy, and it appears to have better outcome preliminarily. In this study, we compared the short-term quality of life (QOL) in patients with esophageal cancer after subtotal esophagectomy via VATS or open surgery. A total of 56 patients who underwent three-incision esophagectomy by the same surgical group from January 2007 to February 2008 were enrolled in this retrospective study. Twenty-seven patients followed VATS (VATS group) and 29 patients followed open surgery (open group). The EORTC core questionnaire (QLQ C-30) together with esophageal-specific module (OES-18) were applied to assess the short-term QOL of the patients before and 2, 4, 16, 24 weeks after operation. In result, all of the global quality scale, functioning scale, general symptom scales (or items) did not show differences before operation between the two groups. Further, the scores of global quality and physical functioning were higher in VATS group than in open group overall after operation, however, the scores of fatigue, pain, dyspnea were lower inversely. In conclusion, VATS shows an overall benefit on QOL for the patients with esophageal cancer during the follow-up of six month after esophagectomy, compared with open surgery.
对于食管癌患者,根治性食管及周围淋巴结切除术是唯一的治愈性治疗选择。传统的开放性食管切除术创伤广泛,恢复缓慢。近年来,电视辅助胸腔镜手术(VATS)已应用于食管切除术,初步显示出更好的效果。本研究比较了 VATS 与开放性手术治疗食管癌患者术后短期生活质量(QOL)。回顾性分析 2007 年 1 月至 2008 年 2 月同一外科组采用三切口食管癌切除术的 56 例患者,其中 27 例行 VATS(VATS 组),29 例行开放性手术(开放组)。采用 EORTC 核心问卷(QLQ C-30)和食管特异性模块(OES-18)评估患者术前及术后 2、4、16、24 周的短期 QOL。结果,两组患者术前全球健康状况量表、功能量表、一般症状量表(或项目)无差异。术后 VATS 组患者全球健康状况和躯体功能评分均高于开放组,而疲乏、疼痛、呼吸困难评分均低于开放组。总之,与开放性手术相比,VATS 可改善食管癌患者术后 6 个月的 QOL。