Department of Thoracic Surgery, Gaozhou People's Hospital, Affiliated to Guangdong Medical University, Guangdong Esophageal Cancer Institute Gaozhou Branch, 89 Xiguan Road, Gaozhou, 525200, Guangdong, People's Republic of China.
BMC Surg. 2023 Mar 18;23(1):58. doi: 10.1186/s12893-023-01903-0.
The purpose of this study was to investigate the effect of our revamped MIE-McKeown operation on postoperative gastrointestinal function recovery.
This revamped MIE-McKeown operation without removing azygos vein arch, bronchial artery and vagus nerve trunk and with the tubular stomach buried throughout esophageal bed and azygos arch, has been implemented from July 2020 to July 2021 by the same medical team of Gaozhou People's Hospital thoracic surgery for 13 times. Preoperative clinical data, main intraoperative indicators and postoperative complications were observed.
All patients had esophageal malignant tumors at the level of middle and lower thoracic non-azygous venous arch, with preoperative clinical stage CT1-2N0M0 stage i-ii. V-vst test was performed on the 7th postoperative day, and 10 patients were found to have no loss of safety/efficacy. There were 2 cases with impaired efficacy and no impaired safety, 1 case with impaired safety. There were 1 cases of pulmonary infection, 1 cases of anastomotic fistula combined with pleural and gastric fistula, 2 cases of hoarseness, 2 cases of arrhythmia, 10 cases of swallowing function were grade i, 2 cases of swallowing function were grade iii, 1 case of swallowing function was grade iv in watian drinking water test one month after operation.
Merit of this revamped MIE-McKeown operation is well preserving the integrity of azygos arch of vagus nerve and bronchial artery, and it is technically safe and feasible. No postoperative mechanical obstruction of thoracostomach, huge thoracostomach and gastrointestinal dysfunction occurs.
本研究旨在探讨改良微创食管癌根治术（MIE-McKeown）对术后胃肠功能恢复的影响。
自 2020 年 7 月至 2021 年 7 月，高州市人民医院胸外科同一医疗团队对 13 例非奇静脉弓水平中下段食管恶性肿瘤患者实施了改良 MIE-McKeown 手术，不游离奇静脉弓、支气管动脉和迷走神经干，管状胃全程埋置于食管床和奇静脉弓，观察患者的术前临床资料、主要术中指标和术后并发症。
所有患者术前临床分期 CT1-2N0M0 Ⅰ-Ⅱ期，均为非奇静脉弓水平中下段食管恶性肿瘤。术后第 7 天行 V-vst 试验，发现 10 例无安全性/疗效丧失，2 例疗效受损但无安全性受损，1 例安全性受损。术后发生肺部感染 1 例，吻合口瘘合并胸胃瘘 1 例，声音嘶哑 2 例，心律失常 2 例。术后 1 个月行饮水试验，吞咽功能分级：Ⅰ级 10 例，Ⅲ级 2 例，Ⅳ级 1 例。
改良 MIE-McKeown 手术保留了奇静脉弓、迷走神经和支气管动脉的完整性，技术上安全可行，无术后胸胃机械性梗阻、巨大胸胃和胃肠功能障碍。
