Feng Ming-Xiang, Wang Qun, Jiang Wei, Wang Hao, Qian Cheng, Tan Li-Jie
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2010 Jan;13(1):33-5.
To compare the outcome between retrosternal and posterior mediastinal gastric tube reconstruction after three-phase esophagectomy.
A total of 107 patients who underwent three-phase esophagectomy between July 2005 and May 2009 were enrolled in this study.
There were 78 men and 29 women. Median age was 62.1 years. The tumor located at upper segment in 20 cases, middle segment in 69 cases and lower segment in 18 cases. There were 55 patients in the posterior mediastinal group and 52 in the retrosternal group. There were no significant differences between two groups in operation time, intraoperative blood loss, duration of chest tube. Hospital stay of retrosternal group was longer as compared to posterior mediastinal group. No death occurred in both groups. Anastomotic leakage occurred more frequently in retrosternal group than that in posterior mediastinal group (26.9% vs 5.5%). Postoperative pneumonia, atelectasis and arrhythmia were not significantly different between two groups.
After three-phase esophagectomy, both retrosternal and posterior mediastinal gastric tube reconstruction can be performed easily and safely. Morbidity of anastomotic leakage is higher in retrosternal reconstruction. Individualized gastric tube reconstruction should be considered.
比较三阶段食管癌切除术后胸骨后与后纵隔胃管重建的效果。
本研究纳入了2005年7月至2009年5月期间接受三阶段食管癌切除术的107例患者。
男性78例，女性29例。中位年龄为62.1岁。肿瘤位于上段20例，中段69例，下段18例。后纵隔组55例，胸骨后组52例。两组在手术时间、术中出血量、胸管留置时间方面无显著差异。胸骨后组的住院时间比后纵隔组更长。两组均无死亡病例。胸骨后组吻合口漏的发生率高于后纵隔组（26.9%对5.5%）。两组术后肺炎、肺不张和心律失常无显著差异。
三阶段食管癌切除术后，胸骨后和后纵隔胃管重建均可轻松、安全地进行。胸骨后重建吻合口漏的发生率较高。应考虑个体化的胃管重建。
