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食管癌切除术后胃管道吻合口钉合线裂开：一种理应被提及却明显被遗漏的并发症。

Staple Line Dehiscence in Gastric Conduit Following Esophagectomy: A Complication Conspicuously Missing a Mention It Deserves.

作者信息

Mathew Anvin, Kaushal Gourav, Ramachandra Deepti, Rakesh Nirjhar Raj, Dhar Puneet

机构信息

Surgical Gastroenterology, All India Institute of Medical Sciences, Rishikesh, IND.

Surgical Gastroenterology, All India Institute of Medical Sciences, Bathinda, IND.

出版信息

Cureus. 2022 Jan 25;14(1):e21581. doi: 10.7759/cureus.21581. eCollection 2022 Jan.

DOI:10.7759/cureus.21581
PMID:35228939
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8867526/
Abstract

Following esophagectomy, anatomical reconstruction with a gastric tube is the most common practice. The construction of the gastric tube is done with staplers nowadays, be it a minimally invasive esophagectomy or a conventional open surgery. Even though anastomotic leak and conduit necrosis are reported widely in the literature, the number of studies on staple line dehiscence is meager in comparison. Management of conduit failure usually sacrifices conduit combined with a diverting cervical esophagostomy. We report a case of successful surgical management of a big staple line dehiscence and 'salvaging of the conduit'.

摘要

食管癌切除术后，用胃管进行解剖重建是最常见的做法。如今，无论是微创食管癌切除术还是传统开放手术，胃管的构建都使用吻合器完成。尽管文献中广泛报道了吻合口漏和管道坏死，但相比之下，关于吻合钉线裂开的研究却很少。管道衰竭的处理通常是牺牲管道并结合行颈段食管转流造口术。我们报告一例成功手术处理大吻合钉线裂开并“挽救管道”的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/cf18a58a49a6/cureus-0014-00000021581-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/3f6e6833edf8/cureus-0014-00000021581-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/3cbcf2b955c4/cureus-0014-00000021581-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/5608c0e9c2ac/cureus-0014-00000021581-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/0848a09aefae/cureus-0014-00000021581-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/cf18a58a49a6/cureus-0014-00000021581-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/3f6e6833edf8/cureus-0014-00000021581-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/3cbcf2b955c4/cureus-0014-00000021581-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/5608c0e9c2ac/cureus-0014-00000021581-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/0848a09aefae/cureus-0014-00000021581-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7e/8867526/cf18a58a49a6/cureus-0014-00000021581-i05.jpg

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本文引用的文献

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Comparison of laparoscopic sleeve gastrectomy leak rates in five staple-line reinforcement options: a systematic review.五种缝钉线加固方案在腹腔镜袖状胃切除术中漏率的比较：系统评价。
Surg Endosc. 2020 Jan;34(1):396-407. doi: 10.1007/s00464-019-06782-2. Epub 2019 Apr 16.
2
Gastric-tube versus whole-stomach esophagectomy for esophageal cancer: A systematic review and meta-analysis.食管癌胃管与全胃食管切除术：一项系统评价和荟萃分析。
PLoS One. 2017 Mar 7;12(3):e0173416. doi: 10.1371/journal.pone.0173416. eCollection 2017.
3
Management of gastric conduit dehiscence with self-expanding metal stents: a case report on salvaging the gastric conduit.
使用自膨式金属支架治疗胃代食管吻合口裂开：一例挽救胃代食管的病例报告
J Cardiothorac Surg. 2017 Jan 25;12(1):4. doi: 10.1186/s13019-017-0570-z.
4
Conservative reconstruction using stents as salvage therapy for disruption of esophago-gastric anastomosis.使用支架进行保守重建作为食管胃吻合口破裂的挽救治疗。
World J Gastroenterol. 2015 Jul 28;21(28):8723-9. doi: 10.3748/wjg.v21.i28.8723.
5
International Consensus on Standardization of Data Collection for Complications Associated With Esophagectomy: Esophagectomy Complications Consensus Group (ECCG).食管癌切除术后并发症数据收集标准化国际共识：食管癌切除术后并发症共识小组（ECCG）
Ann Surg. 2015 Aug;262(2):286-94. doi: 10.1097/SLA.0000000000001098.
6
The value of protecting the longitudinal staple line with invaginating sutures during esophageal reconstruction by gastric tube pull-up.胃管提拉法食管重建中使用内翻缝合保护纵向吻合口的价值。
Dig Surg. 2009;26(4):337-41. doi: 10.1159/000235825. Epub 2009 Aug 29.
7
Gastric conduit staple line after esophagectomy: to oversew or not?食管切除术后胃管道吻合钉线：是否进行缝合？
J Thorac Cardiovasc Surg. 2006 Dec;132(6):1491-2. doi: 10.1016/j.jtcvs.2006.08.017.