Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, 710061, China.
Hospital 521 of China's Ordnance Industry Group, Xi'an, 710065, China.
World J Surg Oncol. 2018 May 24;16(1):97. doi: 10.1186/s12957-018-1330-9.
Short- and long-term health-related quality of life (HRQL) was severely affected after surgery. This study aimed to assess the direction and duration of HRQL from 3- to 24-month follow-ups after minimally invasive esophagectomy (MIE) for esophageal cancer.
A systematic literature search in MEDLINE, EMBASE, and the Cochrane database was performed for all potentially relevant studies published until February 2017. Studies were included if they addressed the question of HRQL with OERTC-QLQ-C30 and OES18. Primary outcomes were HRQL change at 3-month follow-up. Secondary outcomes were HRQL change from 3-, 6- (short-term) to 12- (mid-term), and/or 24-month (long-term) follow-ups.
Six articles were included to estimate the change in 24 HRQL outcomes after MIE. Most of the patients' HRQL outcomes deteriorated at short-term follow-up and some lasted to mid- or long-term after MIE. Patients' physical function and global QOL deteriorated from short- to long-term follow-ups, and emotional function had no change. The directions of dyspnea, pain, fatigue, insomnia, constipation, diarrhea, cough, and speech problems were increased. The deterioration in global function lasted 6 months, the increase in constipation and speech problems lasted 12 months, and insomnia increased more than 12 months after MIE.
The emotional function had no change after MIE. The global QOL become worse during early postoperative period; the symptoms of constipation, speech problems, and insomnia increased for a long time after MIE.
微创手术（MIE）治疗食管癌后，患者的短期和长期健康相关生活质量（HRQL）均受到严重影响。本研究旨在评估 MIE 后 3 至 24 个月随访期间 HRQL 的变化方向和持续时间。
对 MEDLINE、EMBASE 和 Cochrane 数据库进行系统文献检索，以查找直至 2017 年 2 月发表的所有潜在相关研究。如果研究使用 OERTC-QLQ-C30 和 OES18 来解决 HRQL 问题，则将其纳入研究。主要结局为 3 个月随访时的 HRQL 变化。次要结局为 3、6（短期）至 12（中期）和/或 24 个月（长期）随访时的 HRQL 变化。
纳入 6 项研究来评估 MIE 后 24 项 HRQL 结局的变化。大多数患者的 HRQL 结局在短期随访时恶化，有些在 MIE 后持续到中期或长期。患者的身体功能和整体生活质量从短期随访到长期随访逐渐恶化，而情绪功能没有变化。呼吸困难、疼痛、疲劳、失眠、便秘、腹泻、咳嗽和言语问题的方向均加重。整体功能的恶化持续 6 个月，便秘和言语问题的增加持续 12 个月，失眠在 MIE 后增加超过 12 个月。
MIE 后情绪功能没有变化。全球生活质量在术后早期恶化；便秘、言语问题和失眠的症状在 MIE 后很长一段时间内都在增加。
