Comparison of Up-Front Minimally Invasive Esophagectomy versus Open Esophagectomy on Quality of Life for Esophageal Squamous Cell Cancer

Abstract

This study investigates whether minimally invasive esophagectomy (MIE) is a safe and effective way for patients with resectable esophageal cancer by comparing the short-term quality of life (QOL) after minimally invasive esophagectomy and open esophagectomy (OE). A total number of 104 patients who underwent esophagectomy from January 2013 to March 2014 were enrolled in this study. These patients were divided into two groups (MIE and OE group). Three scoring scales of quality of life were used to evaluate QOL before the operation and at the first, third, sixth and twelfth months after MIE or OE, which consist of Karnofshy performance scale (KPS), the European Organization for Research and Treatment questionnaire QLQC-30 (EORTC QLQC-30) and esophageal cancer supplement scale (OES-18). The MIE group was higher than the OE group in one-year survival rate (92.54% vs. 72.00%). Significant differences between the two groups were observed in intraoperative bleeding volume (158.53 ± 91.07 mL vs. 228.97 ± 109.33 mL, p = 0.001), and the incidence of postoperative pneumonia (33.33% vs. 58.62%, p = 0.018). The KPS of MIE group was significantly higher than the OE group at the first (80 vs. 70, p = 0.004 < 0.05), third (90 vs. 80, p = 0.006 < 0.05), sixth (90 vs. 80, p = 0.007 < 0.05) and twelfth months (90 vs. 80, p = 0.004 < 0.05) after surgery. The QLQC-30 score of MIE group was better than OE group at first and twelfth months after the operation. The OES-18 score of MIE group was significantly better than OE group at first, sixth and twelfth months after surgery. The short-term quality of life in MIE group was better than OE group.

Quality of Life and Independent Factors Associated with Poor Digestive Function after Ivor Lewis Esophagectomy

“…Thus, open or hybrid surgical access, high and ECOG scores, (neo)adjuvant treatment, ICU readmission, and SCC predicted impaired functional outcome. Hence, our results confirm the findings of others that open access surgery leads to worse functional outcomes [13,38]. Because long-term oncologic outcomes after open and minimally invasive procedures are equivalent [39], our results underscore the importance of less invasive surgical procedures in patients undergoing esophagectomy.…”

Quality of Life in Patients Undergoing Surgery for Upper GI Malignancies

“…When performing esophagectomy, surgeons often face a dilemma in choosing between the latest Minimally Invasive Esophagectomy (MIE) and conventional surgery. Selecting the most HRQL-compatible surgical method is a complex process, as six recent original research studies have shown a direct correlation between MIE and poor postoperative HRQL [ 40 ]. Specifically, overall function worsened and dyspnea, pain, fatigue, insomnia, constipation, diarrhea, cough, and speech problems persisted for six months after MIE.…”

“…Specifically, overall function worsened and dyspnea, pain, fatigue, insomnia, constipation, diarrhea, cough, and speech problems persisted for six months after MIE. Speech problems and constipation persisted for 12 months and insomnia persisted for longer than 12 months [ 40 ]. Consequently, MIE and traditional surgery techniques have similar oncological outcomes.…”

“…While MIE is proven to be more beneficial in the short-term, the type of surgery linked to a greater long-term advantage remains unknown [ 41 ]. At the first, sixth, and twelfth-month follow-ups after surgery, MIE significantly outperformed esophagectomy in terms of QLQC-30 and OES-18 scores [ 40 ].…”