Wang Gaoxiang, Sun Xiaohui, Li Tian, Xu Meiqing, Guo Mingfa, Liu Changqing, Xie Mingran
Department of Thoracic Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Front Surg. 2023 Jan 6;9:981576. doi: 10.3389/fsurg.2022.981576. eCollection 2022.
To compare the short-term outcomes and postoperative quality of life in patients with esophageal cancer between inflatable videoasisted mediastinoscopic transhiatal esophagectomy (IVMTE) and minimally invasive Mckeown esophagectomy (MIME), and to evaluate the value of IVMTE in the surgical treatment of esophageal cancer.
A prospective, nonrandomized study was adopted. A total of 60 esophageal cancer patients after IVMTE and MIME December 2019 to January 2022 were included. Among them, 30 patients underwent IVMTE and 30 patients underwent MIME. Shortterm outcomes (including the operation time, intraoperative blood loss, postoperative drainage 3 days, total postoperative tube time, postoperative hospital stay, number and number of thoracic lymph node dissection stations, postoperative complications and so on), postoperative quality of life, [including Quality of Life Core Questionnaire (QLQ-C30) and the esophageal site-specific module (QLQ-OES18)] were compared between the 2 groups.
The operation time, intraoperative blood loss, postoperative drainage volume and total postoperative intubation time in IVMTE group were significantly lower than those in MIME group ( < 0.05). A total of 22 patients had postoperative complications, including 7 patients in IVMTE group (23.3%) and 15 patients in MIME group (50.0%). There was significant difference between the two groups ( = 0.032). The physical function, role function, cognitive function, emotional function and social function and the overall health status in the IVMTE group were higher than those in the MIME group at all time points after operation, while the areas of fatigue, nausea, vomiting and pain symptoms in the MIME group were lower than those in the MIME group at all time points after operation.
IVMTE is a feasible and safe alternative to MIME. Therefore, when the case is appropriate, IVMTE should be given priority, which is conducive to postoperative recovery and improve the quality of life of patients after operation.
比较充气式电视辅助纵隔镜经裂孔食管切除术（IVMTE）与微创麦克尤恩食管切除术（MIME）治疗食管癌患者的短期疗效和术后生活质量，评估IVMTE在食管癌手术治疗中的价值。
采用前瞻性、非随机研究。纳入2019年12月至2022年1月行IVMTE和MIME的60例食管癌患者。其中，30例行IVMTE，30例行MIME。比较两组患者的短期疗效（包括手术时间、术中出血量、术后3天引流量、术后总置管时间、术后住院时间、胸段淋巴结清扫站数及术后并发症等）、术后生活质量[包括生活质量核心问卷（QLQ-C30）和食管特异性模块（QLQ-OES18）]。
IVMTE组的手术时间、术中出血量、术后引流量及术后总置管时间均显著低于MIME组（P<0.05）。共有22例患者发生术后并发症，其中IVMTE组7例（23.3%），MIME组15例（50.0%）。两组间差异有统计学意义（P=0.032）。IVMTE组术后各时间点的身体功能、角色功能、认知功能、情感功能、社会功能及总体健康状况均高于MIME组，而MIME组术后各时间点的疲劳、恶心、呕吐及疼痛症状等方面低于IVMTE组。
IVMTE是MIME可行且安全的替代方法。因此，在病例合适时，应优先选择IVMTE，这有利于术后恢复并提高患者术后生活质量。
