ObjectiveTo evaluate the impact of video-assisted thoracoscopic surgery (VATS) esophagectomy and routine operation on the short-term quality of life in patients with esophageal cancer. MethodsFrom January 2012 through January 2014, 157 esophageal cancer patients were classified into a VATS group (n=42) and a routine operation group (n=115) in our hospital. All patients in the two groups completed the Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ)-C30 and QLQ-OES18 at one, six and 12 months after operation separately. ResultsAt the end of 6, 12 months after operation, the evaluation on global health status was higher in the VATS group(68.8±12.3 vs. 62.7±13.7, P<0.05; 76.2±10.4 vs. 68.6±8.8, P<0.05). At the end of 1, 6, 12 months after operation, the scores of symptom pain were less significantly in the VATS group than those in the routine operation group (P<0.05). One month after operation, the score of active ability in the VATS group was higher (P<0.05). At the end of 6, 12 months after operation, the score of emotional function and social role in the VATS group was higher (P<0.05). At the end of 12 months after operation, the score of role function and cognitive function in the VATS group was also higher (P<0.05). ConclusionVATS is of better effect on improving short-term quality of life of esophageal cancer patients compared with routine operation.
ObjectiveTo explore risk factors of pneumonia of patients after esophagectomy and its preventive measures. MethodsClinical data of 258 patients undergoing esophagectomy in Guangyuan Central Hospital between 2009 and 2012 were retrospectively analyzed. According to whether they had pneumonia after esophagectomy, all the 258 patients were divided into 2 groups. In the pneumonia group, there were 86 patients including 62 males and 24 females with their age of 65.1 (45-84)years, who all had pneumonia after esophagectomy. In the control group, there were 172 patients including 124 males and 48 females with their age of 60.2 (43-78)years, who didn't have pneumonia after esophagectomy. Preoperative pulmonary function, age, smoking history, anastomotic location, intraoperative blood loss, pneumonia and other perioperative complications were compared between the 2 groups. Multivariate logistic regression was performed to analyze risk factors of pneumonia after esophagectomy. ResultsUnivariate analysis showed that incidences of moderate or severe pulmonary dysfunction, smoking history (≥400 cigarettes per year), old age (≥65 years), laryngeal recurrent nerve injury, perioperative blood loss (≥1 000 ml), operation time longer than 4 hours, and preoperative diabetes mellitus of the pneumonia group were significantly higher than those of the control group (P < 0.05). Multivariate logistic regression analysis showed that moderate or severe pulmonary dysfunction (P=0.022), smoking history (≥400 cigarettes per year, P=0.000), old age (≥65 years, P=0.026), laryngeal recurrent nerve injury (P=0.002), and perioperative blood loss (≥1000 ml, P=0.020)were main risk factors of pneumonia after esophagectomy. ConclusionsModerate or severe pulmonary dysfunction, smoking history (≥400 cigarettes per year), old age (≥65 years), laryngeal recurrent nerve injury and perioperative blood loss (≥1 000 ml)are main risk factors of pneumonia after esophagectomy. Preoperative smoking cessation, pulmonary function exercise, airway preparation, careful hemostasis, and avoidance of laryngeal recurrent nerve injury are helpful to prevent pneumonia after esophagectomy.