A prospective study of quality of life after minimally invasive Sweet esophagectomy for siewert type Ⅱ esophagogastric junction adenocarcinoma
10.3760/cma.j.issn.1001-4497.2018.07.001
- VernacularTitle:微创Sweet食管切除术治疗SiewertⅡ型食管胃交界腺癌近期生活质量分析
- Author:
Mingran XIE
1
;
Changqing LIU
;
Mingfa GUO
;
Xiaohui SUN
;
Guangwen XU
;
Xinyu MEI
;
Meiqing XU
Author Information
1. 中国科学技术大学附属第一医院胸外科
- Keywords:
Esophagogastric junction adenocarcinoma;
Thoracoscopy;
Laparoscopy;
Quality of life
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(7):385-390
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the impact of minimally invasive Sweet esophagectomy on short term quality of life for patients with Siewert typeⅡesophagogastric junction adenocarcinoma.Methods From January 2015 to September 2017, 60 patients underwent minimally invasive Sweet esophagectomy(MISE group) and 60 patients underwent open sweet esophagecto-my(OSE group).The questionnaires(EORTC QLQ-C30 and QLQ-OES18) were applied to assess the quality of life of the pa-tients before and 1,2,4,8 weeks after operation.The clinicopathologic factors, operational factors and postoperative complica-tions of the two groups were compared by t test and χ2test.The Mann-Whitney test was used to test for statistical significance because the responses were not normally distributed.Results The two groups were similar in terms of clinical characteristics and preoperative QOL scores(P ＞0.05).The MISE group was associated with a significant decrease in surgical blood loss [(88.1 ±32.2)ml vs.(119.5 ±34.1)ml, t＝5.052, P＝0.001], chest tube duration[(8.1 ±4.4)d vs.(10.5 ±4.0)d, t＝3.110, P＝0.002] and postoperative stay[(9.1 ±4.6)d vs.(11.6 ±3.8)d, t＝3.167, P＝0.002] relative to the OSE group.The postoperative in-hospital mortality and total morbidity did not differ between the two groups (P＞0.05).The MISE group was associated with significantly fewer respiratory complications than the OSE group (8.5%vs.22.7%, t＝4.063, P＝ 0.044).The MISE group was associated with a significant increase in hospitalization costs [(54 106 ±4 352) yuan vs. (51 143 ±5 315)yuan, P＝0.001] relative to the OSE group.MISE group gained higher scores in physical function, role func-tion, emotional function, Global QOL and lower scores in pain, fatigue, acid reflux than OSE group after surgery.Conclusion Our minimally invasive technique for Siewert typeⅡesophagogastric junction adenocarcinoma can be safely and effectively performed with favorable early outcomes.Compared to conventional open Sweet approach, MISE impoved the short term quality of life after surgery.
