Vrba R, Aujeský R, Stašek M, Vomáčková K, Tesaříková J, Hlaváčková L, Cincibuch J, Vrána D, Horáková M, Zapletalová J, Neoral Č
Rozhl Chir. 2018 Winter;97(7):342-348.
The authors present the results of surgical treatment of esophageal cancer at Department of Surgery I, University Hospital Olomouc between 20062016. The aim of the study was to use retrospective analysis to evaluate the results of patients operated for esophageal cancer and statistically evaluate the results based on the type of surgical approach (transhiatal, transthoracic). Method: A total of 240 patients with esophageal cancer were operated at Department of Surgery I between the beginning of 2006 and the end of 2016. We evaluated respiratory complications, the incidence of anastomotic fistula and complications based on the Clavien-Dindo classification of complications, based on the type of surgical approach selected (transhiatal or transthoracic esophagectomy). Results: The patient set included 207 men (86.3%) and 33 women (13.7%). The mean patient age was 60.4 years. The histological type was adenocarcinoma in 145 (60.4%) and squamous cell carcinoma in 90 (37.5%) patients; another type of carcinoma was observed in 5 cases. Transhiatal esophagectomy was performed in 194 patients (80.2%) (transhiatal laparoscopic in 190 and classic Orringer in 4 patients). Transthoracic approach was used in 46 patients (19.2%), thoracoscopic in 16, and thoracotomic in 30 patients. A gastric conduit was used in 236 patients and coloplasty was performed in 4 patients. The mean duration of surgery was 217 min for the transhiatal approach, 239 min for the thoracoscopic approach and 277 min for the thoracotomic approach. Total blood loss per patient was 562 ml on average for all the operated patients. Peri- or postoperative blood transfusions were administered to 148 patients. Lymphadenectomy was performed as part of the procedure in all patients; the mean of 16.1 lymph nodes were removed. The average hospital stay was 20.7 days. In the patient set, 30-day mortality included 12 patients (respiratory complications 10, MI 1, conduit necrosis 1) and 90-day mortality included 4 (multi organ failure during ARDS). Based on statistical analysis, the incidence of respiratory complications significantly correlated with ASA classification (p=0.0001) and Clavien-Dindo classification (p.
作者展示了2006年至2016年期间奥洛穆茨大学医院第一外科对食管癌进行手术治疗的结果。本研究的目的是通过回顾性分析评估接受食管癌手术患者的结果，并根据手术方式（经裂孔、经胸）对结果进行统计学评估。方法：2006年初至2016年底，共有240例食管癌患者在第一外科接受手术。我们根据所选手术方式（经裂孔或经胸食管癌切除术），评估了呼吸并发症、吻合口瘘的发生率以及基于Clavien-Dindo并发症分类的并发症情况。结果：患者组包括207名男性（86.3%）和33名女性（13.7%）。患者平均年龄为60.4岁。组织学类型为腺癌的有145例（60.4%），鳞状细胞癌的有90例（37.5%）；另外5例为其他类型的癌。194例患者（80.2%）接受了经裂孔食管癌切除术（190例为经裂孔腹腔镜手术，4例为经典的奥林格手术）。46例患者（19.2%）采用经胸手术方式，其中16例为胸腔镜手术，30例为开胸手术。236例患者使用了胃管道，4例患者进行了结肠成形术。经裂孔手术的平均手术时长为217分钟，胸腔镜手术为239分钟，开胸手术为277分钟。所有接受手术患者的平均每人总失血量为562毫升。148例患者接受了围手术期或术后输血。所有患者手术过程中均进行了淋巴结清扫；平均清扫淋巴结16.1枚。平均住院时间为20.7天。在患者组中，30天死亡率包括12例患者（呼吸并发症10例、心肌梗死1例、管道坏死1例），90天死亡率包括4例（急性呼吸窘迫综合征期间多器官功能衰竭）。基于统计分析，呼吸并发症的发生率与美国麻醉医师协会（ASA）分级（p = 0.0001）和Clavien-Dindo分级（p...
