Department of Cardiothoracic Surgery, Fuling Central Hospital, NO 2, Gaosuntang Road, Fuling District, Chongqing, Fuling, 408000, China.
World J Surg Oncol. 2017 Aug 30;15(1):166. doi: 10.1186/s12957-017-1219-z.
The objective of the study is to explore the effects of retrosternal and prevertebral lifting paths of the tubular stomach on postoperative complications of patients undergoing cervical anastomosis in thoracoscopic and laparoscopic esophagectomy.
Sixty-three patients were retrospectively analyzed. The patients received thoracoscopic and laparoscopic esophagectomy by the same surgeon. According to the path by which the stomach was lifted upward, the patients were divided into two groups: the retrosternal path group (32 patients) and the prevertebral path group (31 patients). Operative indications and complications of postoperative patients in these two groups were observed.
There was no statistically significant difference in the time duration of surgery, amount of bleeding, number of dissected lymph node, and postoperative hospitalization time between the retrosternal and prevertebral lifting paths (P > 0.05). Furthermore, the two groups did not show significant difference in the incidence rate of postoperative anastomosis fistula complications (P = 0.702). Instead, the amount of postoperative gastric drainage and the incidence rates of the pulmonary infection were significantly lower in the retrosternal path group than in the prevertebral path group, respectively (P = 0.001, P = 0.012, respectively).
The esophagogastrostomic cervical anastomoses performed via the retrosternal and prevertebral paths are both feasible methods of digestive tract reconstruction. The amount of postoperative gastric drainage volume and the pulmonary infection incidence rate in the retrosternal path group were lower than those in the prevertebral path group. Therefore, gastroesophageal anastomosis via the retrosternal lifting path may be preferably considered for thoracoscopic and laparoscopic surgery for esophageal carcinoma patients.
本研究旨在探讨管状胃经胸骨后和椎体前路径提升对胸腹腔镜食管癌颈部吻合术后并发症的影响。
回顾性分析 63 例患者。这些患者均由同一位外科医生行胸腹腔镜食管癌切除术。根据胃向上提升的路径，将患者分为胸骨后路径组（32 例）和椎体前路径组（31 例）。观察两组患者的手术适应证和术后并发症。
胸骨后路径组和椎体前路径组在手术时间、出血量、淋巴结清扫数量和术后住院时间方面差异均无统计学意义（P＞0.05）。此外，两组术后吻合口瘘并发症的发生率也无显著差异（P=0.702）。相反，胸骨后路径组的术后胃引流量和肺部感染发生率明显低于椎体前路径组（P=0.001，P=0.012）。
经胸骨后和椎体前路径行食管胃颈部吻合术均是可行的消化道重建方法。胸骨后路径组的术后胃引流量和肺部感染发生率均低于椎体前路径组。因此，对于胸腹腔镜食管癌患者，经胸骨后提升路径行胃食管吻合术可能更优。
