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微创 Ivor Lewis 食管切除术(MILE):100 例连续病例的技术和结果。

Minimally Invasive Ivor Lewis Esophagectomy (MILE): technique and outcomes of 100 consecutive cases.

机构信息

Department of Surgery, UF Health - Jacksonville, University of Florida, Jacksonville, 653 West 8th Street, Jacksonville, FL, 32209, USA.

出版信息

Surg Endosc. 2020 Jul;34(7):3243-3255. doi: 10.1007/s00464-020-07529-0. Epub 2020 Apr 6.

Abstract

BACKGROUND

Esophagectomy is the mainstay of therapy for esophageal cancer but is a complex operation that is associated with significantly high morbidity and mortality rates. The primary aim of this study is to report our perioperative outcomes, and long-term survival of Minimally Invasive Ivor Lewis Esophagectomy (MILE).

METHODS

IRB approved retrospective study of 100 consecutive patients who underwent elective MILE from September 2013 to November 2017 at University of Florida, Jacksonville.

RESULTS

Primary diagnosis was esophageal cancer (n = 96) and benign esophageal disease (n = 4). Anastomotic leak rate was observed in 6%; 30- and 90-day mortality rates were 2% and 3%, respectively. The mean length of hospital stay was 10.3 days; 87 patients were discharged to home, while 12 patients were discharged to rehabilitation facility, and there was one in-hospital mortality secondary to graft necrosis. At a mean follow-up was 37 months (2-74), the 3- and 5-year overall survivals are 63.9 ± 5.0% (95% CI 53.3-72.7%) and 60.5 ± 5.3% (95% CI 49.4-69.9%), respectively. The 3- and 5-year disease-free survival is 75.0 ± 4.8% (95% CI 64.2-83.0%) and 70.4 ± 5.5% (95% CI 58.0-80.0%).

CONCLUSION

MILE can be performed with low perioperative mortality, and favorable long-term overall and disease-free survival.

摘要

背景

食管癌的主要治疗方法是食管切除术,但这是一种复杂的手术,其发病率和死亡率都很高。本研究的主要目的是报告我们的围手术期结果以及微创 Ivor Lewis 食管切除术(MILE)的长期生存情况。

方法

对 2013 年 9 月至 2017 年 11 月在佛罗里达大学杰克逊维尔分校接受择期 MILE 的 100 例连续患者进行了机构审查委员会批准的回顾性研究。

结果

主要诊断为食管癌(n=96)和良性食管疾病(n=4)。吻合口漏发生率为 6%;30 天和 90 天死亡率分别为 2%和 3%。平均住院时间为 10.3 天;87 例患者出院回家,12 例患者出院到康复设施,有 1 例院内死亡是由于移植物坏死。在平均 37 个月(2-74 个月)的随访中,3 年和 5 年总生存率分别为 63.9±5.0%(95%CI 53.3-72.7%)和 60.5±5.3%(95%CI 49.4-69.9%)。3 年和 5 年无病生存率分别为 75.0±4.8%(95%CI 64.2-83.0%)和 70.4±5.5%(95%CI 58.0-80.0%)。

结论

MILE 可在较低的围手术期死亡率下进行,并且具有良好的长期总体生存率和无病生存率。

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