AIM： TO evaluate quality of life （QOL） following Ivor Lewis, left transthoracic, and combined thoracoscopic/ laparoscopic esophagectomy in patients with esopha- geal cancer. METHODS： Ninety patients with esophagea...AIM： TO evaluate quality of life （QOL） following Ivor Lewis, left transthoracic, and combined thoracoscopic/ laparoscopic esophagectomy in patients with esopha- geal cancer. METHODS： Ninety patients with esophageal cancer were assigned to Ivor Lewis （/7 = 30）, combined thora- coscopic/laparoscopic （n = 30）, and left transthoracic （n = 30） esophagectomy groups. The QOL-core 30 questionnaire 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 collect- ed 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 trans- thoracic （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 under- going combined thoracoscopic/laparoscopic esopha- gectomy, and most indices had recovered to preopera- tive 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 postop- eratively. Scores in the left transthoracic esophagecto- my group fell between those of the other two groups. CONCLUSION： Compared with Ivor Lewis and left transthoracic esophagectomies, combined thoraco- scopic/laparoscopic esophagectomy enables higher postoperative QOL, making it a preferable surgical ap- proach for esophageal cancer.展开更多
文摘AIM： TO evaluate quality of life （QOL） following Ivor Lewis, left transthoracic, and combined thoracoscopic/ laparoscopic esophagectomy in patients with esopha- geal cancer. METHODS： Ninety patients with esophageal cancer were assigned to Ivor Lewis （/7 = 30）, combined thora- coscopic/laparoscopic （n = 30）, and left transthoracic （n = 30） esophagectomy groups. The QOL-core 30 questionnaire 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 collect- ed 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 trans- thoracic （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 under- going combined thoracoscopic/laparoscopic esopha- gectomy, and most indices had recovered to preopera- tive 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 postop- eratively. Scores in the left transthoracic esophagecto- my group fell between those of the other two groups. CONCLUSION： Compared with Ivor Lewis and left transthoracic esophagectomies, combined thoraco- scopic/laparoscopic esophagectomy enables higher postoperative QOL, making it a preferable surgical ap- proach for esophageal cancer.
