目的:经Sweet入路联合纵隔镜微创食管切除术(MIE-SM)的报道较少。本研究旨在比较MIE-SM与经McKeown入路微创食管切除术(MIE-MC)治疗食管癌的近期、中期和长期疗效,评价MIE-SM在食管癌外科治疗中的价值。方法:采用前瞻性非随机研究。纳入...目的:经Sweet入路联合纵隔镜微创食管切除术(MIE-SM)的报道较少。本研究旨在比较MIE-SM与经McKeown入路微创食管切除术(MIE-MC)治疗食管癌的近期、中期和长期疗效,评价MIE-SM在食管癌外科治疗中的价值。方法:采用前瞻性非随机研究。纳入2014年6月至2016年5月行MIE-SM或MIE-MC术的食管癌患者65例,其中33例接受MIE-SM治疗,32例接受MIE-MC治疗。比较患者短期疗效(包括手术时间、术中失血量、ICU住院时间、术后并发症、术后住院时间、再次手术、开放手术、淋巴结清扫数和30 d病死率)、中期疗效[包括生活质量量表(quality of life questionnaire,QLQ)核心量表(C30)和食管癌补充量表(OES-18),即QLQ-C30和QLQ-OES18]和长期疗效(总生存率和无病生存率)。结果:所有患者均获得根治性切除(R0)。两组患者术后住院时间、术中出血量差异无统计学意义(均P>0.05)。MIE-SM组淋巴结清扫率(24.1±7.3)明显多于MIE-MC组(17.8±5.0,P<0.001)。QLQ-C30结果显示:MIE-SM组的情绪功能、全身健康状况量表评分均明显高于MIE-MC组(分别P=0.025,P<0.001),疼痛评分明显低于MIE-MC组(P=0.013)。QLQ-OES18结果显示:MIE-SM组的疼痛评分明显低于MIE-MC组(P=0.021)。生存分析显示两组的总生存率和无病生存率相似。结论:MIE-SM是治疗食管癌的一种安全且有效的途径,可获得与MIEMC相同的治疗效果,而且与MIE-MC手术相比,患者术后生活质量好,痛苦少。展开更多
For patients with esophageal carcinoma (ESCA), health-related quality of life (HRQoL) has now become an essential feature. To examine the quality of life of preoperative and postoperative ESCA patients, we used the Eu...For patients with esophageal carcinoma (ESCA), health-related quality of life (HRQoL) has now become an essential feature. To examine the quality of life of preoperative and postoperative ESCA patients, we used the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ C-30) and the Quality of Life Questionnaire Oesophageal 18 (QLQ-OES18). Using the EORTC QLQ-C30 and the QLQ-OES18 questionnaire, the analysis of the quality of life scores of 246 patients with oesophageal cancer who were operated on at the Sun Yat-sen University Cancer Centre during the period 2013 to 2015 was carried out. Differences between pre- and post-surgical EORTC QLQ C-30 and QLQ-OES18 scores were examined using the Student’s t-test. Patients’ global health status (QoL) decreased significantly one month after the operation but gradually recovered within a year. In terms of the role function, the emotional function, the cognitive function, and the perception and function variants, EORTC QLQ-C30 and QLQ-OES18 scores increased statistically significantly, as did clinical signs variables such as exhaustion, nausea, vomiting, pain, sleeplessness, decreased appetite, stomach pain, and economic hardship. After surgery, there was an improvement in functional and symptom domains in esophageal carcinoma patients. EORTC QLQ-C30 and QLQ-OES18 can be used to assess the HRQoL before and after surgical procedures.展开更多
基金supported by the National Cancer Center Climb Fund (NCC201818B59)Health Commission of Hunan Province(C2019074),China。
文摘目的:经Sweet入路联合纵隔镜微创食管切除术(MIE-SM)的报道较少。本研究旨在比较MIE-SM与经McKeown入路微创食管切除术(MIE-MC)治疗食管癌的近期、中期和长期疗效,评价MIE-SM在食管癌外科治疗中的价值。方法:采用前瞻性非随机研究。纳入2014年6月至2016年5月行MIE-SM或MIE-MC术的食管癌患者65例,其中33例接受MIE-SM治疗,32例接受MIE-MC治疗。比较患者短期疗效(包括手术时间、术中失血量、ICU住院时间、术后并发症、术后住院时间、再次手术、开放手术、淋巴结清扫数和30 d病死率)、中期疗效[包括生活质量量表(quality of life questionnaire,QLQ)核心量表(C30)和食管癌补充量表(OES-18),即QLQ-C30和QLQ-OES18]和长期疗效(总生存率和无病生存率)。结果:所有患者均获得根治性切除(R0)。两组患者术后住院时间、术中出血量差异无统计学意义(均P>0.05)。MIE-SM组淋巴结清扫率(24.1±7.3)明显多于MIE-MC组(17.8±5.0,P<0.001)。QLQ-C30结果显示:MIE-SM组的情绪功能、全身健康状况量表评分均明显高于MIE-MC组(分别P=0.025,P<0.001),疼痛评分明显低于MIE-MC组(P=0.013)。QLQ-OES18结果显示:MIE-SM组的疼痛评分明显低于MIE-MC组(P=0.021)。生存分析显示两组的总生存率和无病生存率相似。结论:MIE-SM是治疗食管癌的一种安全且有效的途径,可获得与MIEMC相同的治疗效果,而且与MIE-MC手术相比,患者术后生活质量好,痛苦少。
文摘For patients with esophageal carcinoma (ESCA), health-related quality of life (HRQoL) has now become an essential feature. To examine the quality of life of preoperative and postoperative ESCA patients, we used the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ C-30) and the Quality of Life Questionnaire Oesophageal 18 (QLQ-OES18). Using the EORTC QLQ-C30 and the QLQ-OES18 questionnaire, the analysis of the quality of life scores of 246 patients with oesophageal cancer who were operated on at the Sun Yat-sen University Cancer Centre during the period 2013 to 2015 was carried out. Differences between pre- and post-surgical EORTC QLQ C-30 and QLQ-OES18 scores were examined using the Student’s t-test. Patients’ global health status (QoL) decreased significantly one month after the operation but gradually recovered within a year. In terms of the role function, the emotional function, the cognitive function, and the perception and function variants, EORTC QLQ-C30 and QLQ-OES18 scores increased statistically significantly, as did clinical signs variables such as exhaustion, nausea, vomiting, pain, sleeplessness, decreased appetite, stomach pain, and economic hardship. After surgery, there was an improvement in functional and symptom domains in esophageal carcinoma patients. EORTC QLQ-C30 and QLQ-OES18 can be used to assess the HRQoL before and after surgical procedures.
