Taioli Emanuela, Schwartz Rebecca M, Lieberman-Cribbin Wil, Moskowitz Gil, van Gerwen Maaike, Flores Raja
Department of Population Health Science and Policy, Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Population Health Science and Policy, Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health Hofstra Northwell School of Medicine, Great Neck, New York.
Semin Thorac Cardiovasc Surg. 2017;29(3):377-390. doi: 10.1053/j.semtcvs.2017.08.013. Epub 2017 Aug 24.
Although esophageal cancer is rare in the United States, 5-year survival and quality of life (QoL) are poor following esophageal cancer surgery. Although esophageal cancer has been surgically treated with esophagectomy through thoracotomy, an open procedure, minimally invasive surgical procedures have been recently introduced to decrease the risk of complications and improve QoL after surgery. The current study is a systematic review of the published literature to assess differences in QoL after traditional (open) or minimally invasive esophagectomy. We hypothesized that QoL is consistently better in patients treated with minimally invasive surgery than in those treated with a more traditional and invasive approach. Although global health, social function, and emotional function improved more commonly after minimally invasive surgery compared with open surgery, physical function and role function, as well as symptoms including choking, dysphagia, eating problems, and trouble swallowing saliva, declined for both surgery types. Cognitive function was equivocal across both groups. The potential small benefits in global and mental health status among those who experience minimally invasive surgery should be considered with caution given the possibility of publication and selection bias.
尽管食管癌在美国较为罕见，但食管癌手术后的5年生存率和生活质量（QoL）较差。虽然食管癌一直通过开胸食管切除术这种开放性手术进行外科治疗，但最近引入了微创手术来降低并发症风险并改善术后生活质量。本研究是对已发表文献的系统综述，以评估传统（开放）或微创食管切除术后生活质量的差异。我们假设，接受微创手术治疗的患者的生活质量始终优于接受更传统的侵入性手术治疗的患者。尽管与开放手术相比，微创手术后总体健康、社会功能和情感功能更常得到改善，但两种手术类型的身体功能和角色功能，以及包括呛噎、吞咽困难、进食问题和吞咽唾液困难等症状均有所下降。两组的认知功能不明确。鉴于存在发表偏倚和选择偏倚的可能性，对于接受微创手术的患者在总体和心理健康状况方面潜在的微小益处应谨慎考虑。
