Department of Thoracic Surgery, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Baiziting 42, Xuanwu District, Nanjing, 210009, Jiangsu, China.
Department of Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550025, China.
World J Surg Oncol. 2020 Dec 9;18(1):325. doi: 10.1186/s12957-020-02093-2.
Total endoscopic Ivor-Lewis esophagectomy is a challenging, complex, and costly operation. These disadvantages restrict its wide application. The aim of this study was to compare the modified reverse-puncture anastomotic technique and traditional technique for total minimally invasive Ivor-Lewis esophagectomy.
In this cohort retrospective study, all patients with medial and lower squamous cell carcinoma of esophagus from February 2014 and June 2018 were divided into two groups according to the surgical method, which were modified reverse-puncture anastomotic technique group and traditional technique group. The operation time, intraoperative bleeding volume, complications, and cost of the two groups were compared.
Forty-eight patients in the modified reverse-puncture anastomotic technique group while 54 patients in the traditional technique group were included. The operation time was 293.4 ± 57.2 min in the modified reverse-puncture anastomotic technique group, which was significantly shorter than that in the traditional technique group (353.4 ± 64.1 min) (P < 0.05). The intraoperative bleeding volume of modified reverse-puncture anastomotic technique group was 157.3 ± 107.4 ml, while it was 191.9 ± 123.6 ml in traditional technique group (P = 0.14). There were similar complications between the two groups. The cost of modified reverse-puncture anastomotic and traditional technique in our hospital were and 72 ± 13 and 83 ± 41 thousand Yuan, respectively (P = 0.08).
The good short-term outcomes that were achieved suggested that the use of modified reverse-puncture anastomotic technique is safe and feasible for total endoscopic Ivor-Lewis esophagectomy.
全内镜 Ivor-Lewis 食管切除术是一项具有挑战性、复杂性和高成本的手术。这些缺点限制了其广泛应用。本研究旨在比较改良反向穿刺吻合技术与传统全微创 Ivor-Lewis 食管切除术的效果。
本回顾性队列研究中，根据手术方法将 2014 年 2 月至 2018 年 6 月所有中下段食管鳞癌患者分为改良反向穿刺吻合技术组和传统技术组。比较两组患者的手术时间、术中出血量、并发症和费用。
改良反向穿刺吻合技术组 48 例，传统技术组 54 例。改良反向穿刺吻合技术组手术时间为 293.4 ± 57.2 分钟，明显短于传统技术组的 353.4 ± 64.1 分钟（P < 0.05）。改良反向穿刺吻合技术组术中出血量为 157.3 ± 107.4 ml，传统技术组为 191.9 ± 123.6 ml（P = 0.14）。两组并发症发生率相似。我院改良反向穿刺吻合和传统技术的费用分别为 72 ± 13 万和 83 ± 41 万元（P = 0.08）。
改良反向穿刺吻合技术应用于全内镜 Ivor-Lewis 食管切除术是安全可行的，短期效果良好。
