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微创食管切除术后的短期结局

Short-term outcomes after minimally invasive oesophagectomy.

作者信息

Ainsworth Alan Patrick, Larsen Michael Hareskov, Ladegaard Lars, Eckardt Jens, Fristrup Claus Wilki, Mortensen Michael Bau

出版信息

Dan Med J. 2019 Aug;66(8).

Abstract

INTRODUCTION

Minimally invasive oesophagectomy (MIO) has gained increasing popularity. This study reports the results of the first patients operated using this technique at our department.

METHODS

All procedures were prospectively registered in a database. Patients were followed until death, two years after surgery or 1 January 2019.

RESULTS

A total of 150 procedures were performed (from 23 November 2015 to 27 February 2018). The median proced-ure time decreased from 350 minutes for the initial 75 pa-tients to 320 minutes for the final 75 patients (p < 0.05). Blood loss decreased from 200 ml to 100 ml (p < 0.05), respectively. The conversion rate for the abdominal procedure was 7% for the initial 75 patients and 8% for the final 75 patients (not significant (NS)). For the thoracic procedure, the corresponding figures were 11% and 7% (NS), respectively. Anastomotic leakage was seen in 17% (initial patients) and 11% (final patients) (NS); however, less than 20% of the leakages needed surgical treatment. The median length of post-operative stay was nine days for both groups. For all 150 patients, pulmonary complications were observed in 18% and cardiac complications in 11%. The 30-day mortality rate was 2% and the one-year survival rate was 86% (124 registered patients).

CONCLUSIONS

MIO was introduced at our department with acceptable morbidity and mortality rates and the short-term oncological result was not compromised.

FUNDING

none.

TRIAL REGISTRATION

The study was approved as a quality project by the Region of Southern Denmark (18/37355).

摘要

引言

微创食管切除术(MIO)越来越受欢迎。本研究报告了在我们科室首例使用该技术进行手术的患者的结果。

方法

所有手术均前瞻性地记录在数据库中。对患者进行随访,直至死亡、术后两年或2019年1月1日。

结果

共进行了150例手术(从2015年11月23日至2018年2月27日)。手术中位时间从最初75例患者的350分钟降至最后75例患者的320分钟(p<0.05)。失血量分别从200毫升降至100毫升(p<0.05)。腹部手术的中转率在最初75例患者中为7%,在最后75例患者中为8%(无统计学意义(NS))。对于胸部手术,相应数字分别为11%和7%(NS)。吻合口漏在最初患者中为17%,在最后患者中为11%(NS);然而,不到20%的漏需要手术治疗。两组术后住院中位时间均为九天。在所有150例患者中,观察到肺部并发症的发生率为18%,心脏并发症的发生率为11%。30天死亡率为2%,一年生存率为86%(124例登记患者)。

结论

我们科室引入的MIO具有可接受的发病率和死亡率,且短期肿瘤学结果未受影响。

资金来源

无。

试验注册

该研究被丹麦南部地区批准为质量项目(18/37355)。

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