首页|Quality of life after three kinds of esophagectomy for cancer
Quality of life after three kinds of esophagectomy for cancer
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NETL
NSTL
万方数据
维普
AIM:To evaluate quality of life (QOL) following Ivor Lewis,left transthoracic,and combined thoracoscopic/laparoscopic esophagectomy in patients with esophageal cancer.METHODS:Ninety patients with esophageal cancer were assigned to Ivor Lewis (n =30),combined thoracoscopic/laparoscopic (n =30),and left transthoracic (n =30) esophagectomy groups.The QOL-core 30questionnaire and the supplemental QOL-esophageal module 18 questionnaire for patients with esophageal cancer,both developed by the European Organization for Research and Treatment of Cancer,were used to evaluate patients' QOL from 1 wk before to 24 wk after surgery.RESULTS:A total of 324 questionnaires were collected from 90 patients; 36 postoperative questionnaires were not completed because patients could not be contacted for follow-up visits.QOL declined markedly in all patients at 1 wk postoperatively:preoperative and 1-wk postoperative global QOL scores in the Ivor Lewis,combined thoracoscopic/laparoscopic,and left transthoracic groups were 80.8 ± 9.3 vs 32.0 ± 16.1 (P ＜ 0.001),81.1 ± 9.0 vs 53.3 ± 11.5 (P ＜ 0.001),and 83.6 ± 11.2 vs 46.4 ± 11.3 (P ＜ 0.001),respectively.Thereafter,QOL recovered gradually in all patients.Patients who underwent Ivor Lewis esophagectomy showed the most pronounced decline in QOL; global scores were lower in this group than in the combined thoracoscopic/laparoscopic (P ＜ 0.001) and left transthoracic (P ＜ 0.001) groups at 1 wk postoperatively and was not restored to the preoperative level at 24 wk postoperatively.QOL declined least in patients undergoing combined thoracoscopic/laparoscopic esophagectomy,and most indices had recovered to preoperative levels at 24 wk postoperatively.In the Ivor Lewis and combined thoracoscopic/laparoscopic groups,pain and physical function scores were 78.9 ± 18.5 vs 57.8± 19.9 (P ＜ 0.001) and 59.3 ± 16.1 vs 70.2 ± 19.2 (P =0.02),respectively,at 1 wk postoperatively and 26.1± 28.6 vs 9.5 ± 15.6 (P =0.007) and 88.4 ± 10.5 vs 95.8 ± 7.3 (P =0.003),respectively,at 24 wk postoperatively.Scores in the left transthoracic esophagectomy group fell between those of the other two groups.CONCLUSION:Compared with Ivor Lewis and left transthoracic esophagectomies,combined thoracoscopic/laparoscopic esophagectomy enables higher postoperative QOL,making it a preferable surgical approach for esophageal cancer.
Esophageal cancerQuality of lifeThoracoscopeLaparoscopeEsophagectomy
Jian Zeng、Jin-Shi Liu
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Department of Thoracic Tumor Surgery, Zhejiang Cancer Hospital, Hangzhou 310004, Zhejiang Province, China
NETL
NSTL
万方数据
维普
