Prochazka V, Marek F, Kunovsky L, Svaton R, Grolich T, Moravcik P, Farkasova M, Kala Z
Department of Surgery, University Hospital Brno Bohunice, Faculty of Medicine, Masaryk University , Czech Republic.
Department of Gastroenterology, University Hospital Brno Bohunice, Faculty of Medicine, Masaryk University , Czech Republic.
Ann R Coll Surg Engl. 2018 Sep;100(7):509-514. doi: 10.1308/rcsann.2018.0066. Epub 2018 Jun 18.
Background Stomach preparation by ischaemic conditioning prior to oesophageal resection represents a potential method of reducing the risk of anastomotic complications. This study compares the results of the anastomotic complications of cervical anastomosis after oesophagectomy with a short interval after ischaemic conditioning (group S) and a long interval (group L). Methods Subjects undergoing oesophagectomy for carcinoma after ischaemic conditioning were divided into two groups. Group S had a median interval between ischaemic conditioning and resection of 20 days, while for group L the median interval was 49 days. Anastomotic leak and anastomotic stenosis in relation to the interval between ischaemic conditioning and actual resection were followed. Results After ischaemic conditioning, 33 subjects in total underwent surgery for carcinoma; 19 subjects in group S and 14 subjects in group L. Anastomotic leak incidence was comparable in both groups. Anastomotic stenosis occurred in 21% of cases in group S and 7% of cases in group L (not statistically significant). Conclusions A long interval between ischaemic conditioning and oesophagectomy does not adversely affect the postoperative complications. A lower incidence of anastomosis stenoses was found in subjects with a longer interval, however, given the size of our sample, the statistical significance was not demonstrated. Both groups seem comparable in surgical procedure course and postoperative complications.
背景 在食管切除术前通过缺血预处理来准备胃，是一种降低吻合口并发症风险的潜在方法。本研究比较了缺血预处理后短间隔（S组）和长间隔（L组）行食管切除术后颈部吻合口吻合口并发症的结果。方法 对接受缺血预处理后行食管癌切除术的患者进行分组。S组缺血预处理与切除之间的间隔中位数为20天，而L组的中位数间隔为49天。观察缺血预处理与实际切除之间的间隔与吻合口漏和吻合口狭窄的关系。结果 缺血预处理后，共有33例患者接受了癌症手术；S组19例，L组14例。两组的吻合口漏发生率相当。S组吻合口狭窄发生率为21%，L组为7%（无统计学意义）。结论 缺血预处理与食管切除术之间的长间隔不会对术后并发症产生不利影响。间隔较长的患者吻合口狭窄发生率较低，然而，鉴于我们的样本量，未显示出统计学意义。两组在手术过程和术后并发症方面似乎相当。
