Comparison analysis of efficacy of different surgical approaches for esophageal carcinoma / 重庆医学

ABSTRACT

Objective To explore the difference in curative effect,safety of operation and quality of life between patients with esophageal carcinoma treated by the conventional open surgical approach and those treated by laparoscopic radical resection.Methods A total of 185 patients underwent esophageal cancer surgery in our hospital from January 2010 to December 2013 were retrospectively analysed,including 90 cases accepted laparoscopic radical resection (the minimally invasive group) and 95 patients accepted conventional open radical resection (the traditional group).The perioperative indexes,postoperative survival rate,complications and quality of life between the two groups were recorded and compared.Results No statistically significant difference was found in the operation time and number of lymph node dissected in patients between the two groups (P＞0.05).Compared with the traditional group,the amount of surgical bleeding,percentage of patients using postoperative ventilator,length of postoperative hospital stay and pain score in the minimally invasive group were significantly lower,while the postoperative lung function was better,there were statistically significant differences (P＜0.05).The postoperative complication rate in the minimally invasive group (13.33％) was lower than that in the traditional group (25.26％),there was statistically significant difference (P＜0.05).Three months after operation,the scores of dimensions,including physical function,role function,emotional state,cognitive function and social function,in the minimally invasive group were higher than those in the traditional group (P＜0.05);the scores of dimensions,including fatigue state,nausea and vomiting symptoms,pain,insomnia,difficulty breathing,constipation,diarrhea and loss of appetite,in the minimally invasive group were lower than those in the traditional group (P＜0.05).The 1-year,2-year and 3-year survival rates after operation in the minimally invasive group were 88.89％,73.33％ and 63.33％ respectively,which in the traditional group were 80.00％,65.26 ％ and 55.79 ％ respectively,there was no statistically significant difference between the two groups (P＞0.05).Conclusion The effect of laparoscopic radical resection of esophageal cancer is reliable,which has advantages of less operative trauma,quicker recovery,fewer complications,high quality of life after operation.