Department of Thoracic and Upper Gastrointestinal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
Br J Surg. 2010 Apr;97(4):525-31. doi: 10.1002/bjs.6908.
Open oesophagectomy has a detrimental impact on health-related quality of life (HRQL), with recovery taking up to a year. Minimally invasive oesophagectomy (MIO) may enable a more rapid recovery of HRQL.
Clinical outcomes from consecutive patients undergoing MIO for cancer were recorded between April 2005 and April 2007. Patients completed validated questionnaires, European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-OES18, before surgery and at 6 weeks, 3, 6 and 12 months after surgery.
MIO for cancer or high-grade dysplasia was planned in 62 patients, but abandoned in four owing to occult metastatic disease. Resection was completed in the remaining 58, two having partial conversion to open surgery. There was one in-hospital death and 29 patients developed complications. At 1 year, 52 of 58 patients were alive. Questionnaire response rates were high at each time point (overall compliance 84 per cent). Six weeks after MIO, patients reported deterioration in functional aspects of HRQL and more symptoms than at baseline. However, most improved by 3 months and had returned to baseline levels by 6 months. These levels were maintained 1 year after surgery, with 85 per cent of patients recovering in more than 50 per cent of the HRQL domains.
MIO leads to a rapid restoration of HRQL.
开放性食管癌切除术对健康相关生活质量（HRQL）有不利影响，需要长达一年的时间才能恢复。微创食管癌切除术（MIO）可能使 HRQL 更快恢复。
记录了 2005 年 4 月至 2007 年 4 月期间连续接受 MIO 治疗癌症的患者的临床结果。患者在手术前、手术后 6 周、3 个月、6 个月和 12 个月时完成了经过验证的问卷，欧洲癌症研究与治疗组织的 EORTC QLQ-C30 和 QLQ-OES18 问卷。
计划对 62 例癌症或高级别异型增生患者进行 MIO，但由于隐匿性转移疾病而放弃了 4 例。其余 58 例患者完成了切除术，其中 2 例部分转为开放性手术。有 1 例院内死亡，29 例患者发生并发症。1 年后，58 例患者中有 52 例存活。每个时间点的问卷回复率都很高（总体依从率为 84%）。MIO 后 6 周，患者报告 HRQL 的功能方面恶化，并出现比基线更多的症状。然而，大多数患者在 3 个月时有所改善，并且在 6 个月时恢复到基线水平。这些水平在手术后 1 年内保持不变，85%的患者在超过 50%的 HRQL 领域中恢复。
MIO 导致 HRQL 迅速恢复。
