Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, China.
Dis Esophagus. 2021 Jun 14;34(6). doi: 10.1093/dote/doaa108.
There is growing focus on the relationship between surgical start time and postoperative outcomes. However, the extent to which the operation start time affects the surgical and oncological outcomes of patients undergoing esophagectomy has not previously been studied. The purpose of this retrospective study was to investigate the potential effect of surgical start time on the short- and long-term outcomes for patients who underwent thoracoscopic-laparoscopic McKeown esophagectomy. From September 2009 to June 2019, a total of 700 consecutive patients suffering from esophageal cancer underwent thoracoscopic-laparoscopic McKeown esophagectomy in the Department of Thoracic Surgery at Daping Hospital. Among these patients, 166 esophagectomies were performed on the same day and were classified as the first- or second-start group. Patients in the first-start group were more likely to be older than those in the second-start group: (64.73 vs. 61.28, P = 0.002). In addition, patients with diabetes mellitus were more likely to be first-start cases (8.4 vs. 1.2%). After propensity score matching (52 matched patients in first-start cases and 52 matched patients in second-start cases), these findings were no longer statistically significant. There was no difference in the incidence rate of peri- or postoperative adverse events between the first- and second-start groups. The disease-specific survival rates and disease-free survival rates were comparable between the two groups (P = 0.236 and 0.292, respectively). On the basis of the present results, a later start time does not negatively affect the short- or long-term outcomes of patients undergoing minimally invasive McKeown esophagectomy.
目前人们越来越关注手术开始时间与术后结果之间的关系。然而，手术开始时间对接受胸腔镜腹腔镜 McKeown 食管切除术的患者的手术和肿瘤学结果的影响程度尚未得到研究。本回顾性研究的目的是调查手术开始时间对接受胸腔镜腹腔镜 McKeown 食管切除术的患者的短期和长期结果的潜在影响。2009 年 9 月至 2019 年 6 月，胸外科在大坪医院共对 700 例连续的食管癌患者进行了胸腔镜腹腔镜 McKeown 食管切除术。在这些患者中，166 例手术在同一天进行，分为第一启动组或第二启动组。第一启动组的患者比第二启动组的患者年龄更大：（64.73 岁比 61.28 岁，P=0.002）。此外，糖尿病患者更有可能是第一启动病例（8.4%比 1.2%）。经过倾向评分匹配（第一启动病例中 52 例匹配患者和第二启动病例中 52 例匹配患者）后，这些发现不再具有统计学意义。两组患者的围手术期或术后不良事件发生率无差异。两组患者的疾病特异性生存率和无病生存率相当（P=0.236 和 0.292）。基于本研究结果，微创 McKeown 食管切除术的较晚开始时间不会对患者的短期或长期结果产生负面影响。
