剥脱性食管切除术与经典(奥林格技术)食管切除术后并发症的比较研究
A Comparative Study between the Postoperative Complications of Stripping Esophagectomy and Classic (Orringer's Technique) Esophagectomy.
作者信息
Ahmadinejad Mojtaba, Hashemi Mozaffar, Tabatabai Abbas
机构信息
Department of General Surgery, Faculty of Medicine, Úlborz University of Medical Sciences, Karaj, Iran.
Department of General Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
Surg J (N Y). 2022 Feb 1;8(1):e34-e40. doi: 10.1055/s-0041-1736666. eCollection 2022 Jan.
Recent studies have suggested that morbidity and mortality rate of transhiatal esophagectomy is comparable to that of thoracotomy, calling the need for the modifications in the surgical procedures. Our methodology includes stripping of esophagus by nasogastric tube to reduce the manipulation of thoracic cavity and associated complications. We also present the comparison between the stripping and classic (Orringer's technique) esophagectomy. Patients presenting esophageal carcinoma from 2015 to 2017 were the target of this study. Patients undergoing esophagectomy were randomized to have classic or stripping esophagectomy. Operating time, manipulation time, blood losses during the surgery, duration of hospitalization, volume intake, hypotension time, arrhythmia, and transfusion were the recorded parameters. Complications, such as anastomotic leak, cardiac effects, and morbidity, were also studied. Seventy patients were referred for transhiatal esophagectomy for esophageal carcinoma at the Al Zahra Hospital. Mean ages of patients in the stripping and Orringer group were 64.00 ± 10.57 and 57.42 ± 12.20 years, respectively. Manipulation time, operating time, blood loss during the surgery, and transfusion were statistically significant variables between the two groups. Although volume intake and duration of hospitalization were not significantly different parameters, however, betterment in the outcomes was evident. Substantial decrease in overall complications via stripping method was obtained, hence can be suggested as an effective alternative, to remove the need of thoracotomy, for transhiatal esophagectomy.
近期研究表明,经裂孔食管切除术的发病率和死亡率与开胸手术相当,这就需要对手术方法进行改进。我们的方法包括通过鼻胃管剥离食管,以减少胸腔操作及相关并发症。我们还展示了剥离式与经典式(奥林格技术)食管切除术之间的比较。本研究的对象是2015年至2017年出现食管癌的患者。接受食管切除术的患者被随机分为接受经典式或剥离式食管切除术。记录的参数包括手术时间、操作时间、术中失血、住院时间、摄入量、低血压时间、心律失常和输血情况。还研究了诸如吻合口漏、心脏影响和发病率等并发症。在阿尔扎赫拉医院,有70例患者因食管癌接受经裂孔食管切除术。剥离组和奥林格组患者的平均年龄分别为64.00±10.57岁和57.42±12.20岁。两组之间操作时间、手术时间、术中失血和输血是具有统计学意义的变量。虽然摄入量和住院时间不是显著不同的参数,但结果的改善是明显的。通过剥离方法总体并发症大幅减少,因此可以作为一种有效的替代方法,用于经裂孔食管切除术,无需开胸。