Takeno Shinsuke, Tanoue Yukinori, Hamada Roko, Kawano Fumiaki, Tashiro Kosei, Wada Takashi, Nanashima Atsushi
Department of Surgery, Faculty of Medicine, Miyazaki University Hospital, Miyazaki, Miyazaki, Japan.
Ann Thorac Cardiovasc Surg. 2019 Apr 20;25(2):82-86. doi: 10.5761/atcs.oa.18-00170. Epub 2018 Dec 11.
Approximately half of the patients with esophageal cancer are diagnosed at an advanced stage with inoperable disease. The technique of bypass surgery, which is one of the palliative procedures for esophageal cancer, usually requires the insertion of a drainage tube for clearing secretions from the blind remnant esophagus. Since the artificial drainage tube is sometimes problematic for the patient after discharge from the hospital, drainage tubeless (DRESS) surgery might be preferable. The authors demonstrated the utility of DRESS bypass surgery by adding esophagostomy in the right supraclavicular region in three patients with unresectable esophageal cancer with and without esophago-respiratory fistula. All patients had been able to take per-orally and discharged the hospital. Two of three patients are alive with per-oral intake at 1 year later. This DRESS bypass surgery technique, which has not hardly reported in the literature, could release the patients from the tube trouble after the discharge from the hospital and give the patients the better quality of life.
大约一半的食管癌患者在诊断时已处于晚期，疾病无法手术切除。旁路手术是食管癌的姑息治疗方法之一，通常需要插入引流管以清除盲端残余食管的分泌物。由于人工引流管在患者出院后有时会出现问题，无引流管（DRESS）手术可能更可取。作者通过在三名不可切除的食管癌患者（有或无食管气管瘘）的右锁骨上区域增加食管造口术，证明了DRESS旁路手术的实用性。所有患者均能经口进食并出院。三名患者中有两名在1年后仍能经口进食存活。这种DRESS旁路手术技术在文献中鲜有报道，它可以使患者在出院后摆脱引流管问题，提高患者的生活质量。
