腔镜食管癌根治术对患者术后生存率及近期生活质量的影响

目的比较腔镜食管癌根治术与开放三切口食管癌根治术对食管癌患者术后生存率及近期生活质量的影响。方法回顾性分析2016年2月至2018年2月本院收治的417例食管癌患者的临床资料,根据不同手术方式分为腔镜组(n=305)和开放组(n=112)。腔镜组行单纯胸腔镜食管癌根治术或胸腹联合腔镜食管癌根治术,开放组行开放三切口食管癌根治术。比较两组患者手术相关指标、术后并发症、术后生存率以及近期生活质量。结果腔镜组患者手术时间长于开放组,术中出血量少于开放组,差异有统计学意义(P<0.05)。两组患者清扫淋巴结数比较差异无统计学意义。两组患的术后并发症发生率比较差异无统计学意义。两组TNM分期Ⅰ~Ⅱ期和Ⅲ期患者术后3年累积生存率比较差异均无统计学意义。术后1、3、6、12个月,腔镜组患者的EORTC QLQC-30量表评分均高于开放组,差异有统计学意义(P<0.05)。结论腔镜食管癌根治术具有与放手术相似的术后生存率,且创伤小,近期生活质量高,值得临床推广。

Effect of laparoscopic radical esophageal cancer surgery on patient survival rate and quality of life in the near future

Objective To compare the effects of laparoscopic radical esophageal cancer surgery and open three-incision radical esophageal cancer surgery on postoperative survival rate and quality of life in patients with esophageal cancer.Methods Clinical data of 417 patients with esophageal cancer admitted to our hospital from February 2016 to February 2018 were retrospectively analyzed.According to different surgical methods,they were divided into endoscopic group(n=305)and open group(n=112).Endoscopic group received simple thoracoscopic radical resection of esophageal cancer or thoraco-abdominal combined endoscopic radical resection of esophageal cancer,and open group received open three-incision radical resection of esophageal cancer.The surgical indicators,postoperative complications,postoperative survival rate,and recent quality of life were compared between the two groups.Results The operation time of patients in the endoscopic group was longer than that in the open group,and the intraoperative blood loss was less than that in the open group,the difference was statistically significant(P<0.05).There was no significant difference in the number of dissected lymph nodes between the two groups.There was no significant difference in the incidence of postoperative complications between the two groups,there was no significant difference in 3-year cumulative survival rate between the two groups in TNM stageⅠ-Ⅱand stageⅢ.At 1,3,6,and 12 months after surgery,the EORTC QLQC-30 scale scores of patients in the endoscopic group were higher than those in the open group,and the differences was statistically significant(P<0.05).Conclusion Laparoscopic radical esophageal cancer surgery has the same postoperative survival rate as open surgery,with less trauma and high quality of life in the near future.It is worthy of clinical promotion.