A Periodic Report Of The Prospective Clinical Study Of Different Surgical Approaches Affect On Postoperative Quality Of Life And Overall Survival Rates In Ⅱ,ⅢType AEG Patients

Objective Prospectively analyze the postoperative quality of life index and overall survival rates of Ⅱ,Ⅲ type AEG patients who were implemented radical surgery through The left chest of the lateral incision or abdominal incision. To explore the reasonable operative approach of Ⅱ,Ⅲ type AEG.Methods139cases of patients with Ⅱ,Ⅲtype AEG were prospectively enrolled into the group in Shanxi Tumor Hospital during March2012to September2012.64cases of them in transthoracic approach (TT) group, and75cases in abdominal transhiatal approach (TH) group. Respectively comparing the operative time, the residual incision margin cancer rate, the average number of lymph node dissection, postoperative hospital stay, the average number of days required for gastrointestinal function recovery, the incidence of cardiopulmonary complications, mastomotic leakage rate, postoperative bleeding rate, perioperative mortality, postoperative respiratory function decline rate within1year, the average weight loss after1year, postoperative reflux rate within1year, recurrence and metastasis rate within1year, and1-year survival rate of two groups etc.Results No significant difference(P>0.05) were observed in the operative time, the residual incision margin cancer rate, the average number of days required for gastrointestinal function recovery, the incidence of cardiopulmonary complications, anastomotic leakage rate, postoperative bleeding rate, perioperative mortality, postoperative respiratory function decline rate within1year, the average weight loss after1year, postoperative reflux rate within1year, recurrence and metastasis rate within1year, and1-year survival rate of the two operation approaches. Postoperative hospital stay in transthoracic approach group[(20.8±9.7) d] was longer than abdominal transhiatal approach group [(17.1±6.4) d] with significant difference (P<0.05), the average number of lymph node dissection in transthoracic approach group [(14.5±6.7)]was less than transhiatal approach group [(22.7±12.7)]with significant difference (P<0.05).Conclusion Abdominal approach, through the esophageal hiatus radical surgery is a preferred operative approach of Ⅱ,Ⅲ type AEG. The number of abdominal lymph node dissection was a significant advantage, it may have some influence on the prognosis.