Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Hubei Province, Jiefang Road 238, Wuhan City, 430060, People's Republic of China.
Department of Thoracic Surgery, Nanyang Centre Hospital, Gongnong Road 312, Henan Province, 473000, Nanyang City, People's Republic of China.
J Gastrointest Surg. 2022 Oct;26(10):2033-2040. doi: 10.1007/s11605-022-05414-w. Epub 2022 Aug 1.
Oesophageal replacement by colonic interposition remains a major challenge due to its complexity and high incidence of complications; here we applied the two-stage operation strategy to oesophageal replacement by colonic interposition in high-risk oesophageal cancer patients following gastrectomy.
We performed a retrospective analysis on the data of patients with a history of distal gastrectomy who underwent one-stage and two-stage oesophageal replacement by colonic interposition from February 2012 to February 2020, and explored the relationship between the staging strategy and postoperative outcomes.
The clinical data of 93 patients were collected and analysed. There were no significant differences in the patients' characteristics between the two groups (all p > 0.05), except for comorbidities and Charlson Comorbidity Index (all p < 0.05). The Clavien-Dindo score between the two groups was also not significantly different (p > 0.05). The logistic regression models revealed that patients who had received preoperative therapy had a higher Clavien-Dindo score (p < 0.05), but the stage strategy did not (p > 0.05).
The two-stage operation is feasible in high-risk patients who need to undergo colonic interposition for oesophageal replacement. At the same time, it lowers the technical threshold of colonic interposition for oesophageal replacement, increasing this surgical technique's acceptability.
由于其复杂性和高并发症发生率，结肠间置术替代食管仍然是一个主要挑战；在这里，我们对胃切除术后高危食管癌患者应用两阶段手术策略进行结肠间置术替代食管。
我们对 2012 年 2 月至 2020 年 2 月期间行一期和两期结肠间置术替代食管的远端胃切除术后患者的临床资料进行回顾性分析，并探讨分期策略与术后结局的关系。
共收集 93 例患者的临床资料进行分析。两组患者的一般资料比较，差异均无统计学意义（均 P>0.05），但合并症及 Charlson 合并症指数比较，差异均有统计学意义（均 P<0.05）。两组患者的 Clavien-Dindo 评分比较，差异亦无统计学意义（P>0.05）。Logistic 回归模型显示，接受术前治疗的患者 Clavien-Dindo 评分较高（P<0.05），但分期策略无影响（P>0.05）。
两阶段手术适用于需要结肠间置术替代食管的高危患者。同时，它降低了结肠间置术替代食管的技术门槛，提高了该手术技术的可接受性。
