CAJ | 학술논문

目的：比较胸中段食管癌微创与开放Ivor-Lewis术后患者的生活质量。方法回顾性分析安徽医科大学附属省立医院胸外科2012年3月至2013年6月121例胸中段食管癌患者的临床和随访资料，其中微创食管癌Ivor-Lewis术60例（腔镜组），传统开放食管癌Ivor-Lewis术61例（开放组）。采用生活质量核心量表QLQ-C30和食管癌补充量表QLQ-OES18，及自增的2个项目对两组患者术后生活质量进行比较。结果腔镜组术后4周和12周的总体生活质量、躯体功能、角色功能、社会功能、疲倦、疼痛、呼吸困难及咳嗽困难评分明显优于开放组（P＜0．05），其中，总体生活质量、躯体功能、疲倦及疼痛评分术后24周仍优于开放组（P＜0．05）。另外，腔镜组术后4周、12周和24周的右上肢活动障碍和右侧胸壁麻木评分均明显优于开放组（P＜0．05）。结论微创Ivor-Lewis术治疗胸中段食管癌具有创伤小、恢复快及术后生活质量好的优点，值得临床推广。
목적：비교흉중단식관암미창여개방Ivor-Lewis술후환자적생활질량。방법회고성분석안휘의과대학부속성립의원흉외과2012년3월지2013년6월121례흉중단식관암환자적림상화수방자료，기중미창식관암Ivor-Lewis술60례（강경조），전통개방식관암Ivor-Lewis술61례（개방조）。채용생활질량핵심량표QLQ-C30화식관암보충량표QLQ-OES18，급자증적2개항목대량조환자술후생활질량진행비교。결과강경조술후4주화12주적총체생활질량、구체공능、각색공능、사회공능、피권、동통、호흡곤난급해수곤난평분명현우우개방조（P＜0．05），기중，총체생활질량、구체공능、피권급동통평분술후24주잉우우개방조（P＜0．05）。령외，강경조술후4주、12주화24주적우상지활동장애화우측흉벽마목평분균명현우우개방조（P＜0．05）。결론미창Ivor-Lewis술치료흉중단식관암구유창상소、회복쾌급술후생활질량호적우점，치득림상추엄。
Objective To compare the effect of minimally invasive Ivor-Lewis esophagectomy with traditional Ivor-Lewis esophagectomy on the quality of life in patients with middle thoracic esophageal carcinoma. Methods Retrospective analysis was performed on 121 patients with middle thoracic esophageal carcinoma, of whom sixty patients underwent minimally invasive Ivor-Lewis esophagectomy(endoscopic group) and sixty-one patients underwent traditional Ivor-Lewis esophagectomy (open group). All the items of EORTC questionnaire QLQ-C30, seven items of QLQ-OES18 and two additional items (right upper limbs activity obstacle and numbness of right chest wall) were used to evaluate the quality of life. Results The scores of global quality of life, physical functioning, role functioning, social functioning, fatigue, pain, dyspnea and troublesome coughing were more favourable in endoscopy group than those in open group at 4-week and 12-week after operation (P<0.05). However, the advantage of endoscopy group only sustained in global quality of life , physical functioning and fatigue at 24-week after operation (P<0.05). Furthermore, the scores of pain, right upper limbs activity obstacle and numbness of right chest wall were less in endoscopy group than those in open group at 4-week, 12-week and 24-week after operation. Conclusion Minimally invasive Ivor-Lewis esophagectomy is associated with less trauma , shorter time of recovery and better postoperative quality of life.