麦克尤恩式食管癌切除术后超近端空肠造口术的应用：一项回顾性病例系列研究。
Ultra-Proximal Jejunostomy Application after McKeown-Type Esophagectomy: A Retrospective Case-Series Study.
作者信息
Lin Dongliang, Xu Zhendong, Huang Jinlong, Hong Wenshan, Zhang Weiqing, Lian Luoyu
机构信息
Department of Thoracic Surgery, Quanzhou First Hospital, Quanzhou, 362000 Fujian, China.
出版信息
Gastroenterol Res Pract. 2023 Aug 2;2023:5874332. doi: 10.1155/2023/5874332. eCollection 2023.
BACKGROUND
Jejunostomy is the main form of enteral nutritional support after McKeown-type esophagectomy. However, this requires the jejunum to be secured to the abdominal wall, which can lead to catheter-related complications. Here, we present a new type of jejunostomy, ultra-proximal jejunostomy, which does not require fixation of the jejunum to the abdominal wall.
METHODS
Patients who underwent McKeown-type esophagectomy between January 2021 and March 2022 were included in this study. Postoperative outcomes of patients who underwent ultra-proximal jejunostomy are also presented.
RESULTS
Forty-three patients were able to receive enteral nutritional support via an ultra-proximal jejunostomy after McKeown-type esophagectomy, and no cases of enteral fistulas were observed. The pain in the left lower abdomen largely disappeared after the removal of the jejunostomy tube in all patients, and there was no difficulty in removing the tube. To date, none of these patients have experienced bowel obstruction or jejunal torsion.
CONCLUSION
An ultra-proximal jejunostomy is a safe and feasible method and a better option for enteral nutrition support after McKeown-type esophagectomy.
背景
空肠造口术是麦克尤恩式食管切除术后肠内营养支持的主要形式。然而，这需要将空肠固定于腹壁，这可能导致与导管相关的并发症。在此，我们介绍一种新型空肠造口术，即超近端空肠造口术，它不需要将空肠固定于腹壁。
方法
本研究纳入了2021年1月至2022年3月期间接受麦克尤恩式食管切除术的患者。还介绍了接受超近端空肠造口术患者的术后结果。
结果
43例患者在麦克尤恩式食管切除术后能够通过超近端空肠造口术接受肠内营养支持，未观察到肠瘘病例。所有患者在拔除空肠造口管后左下腹疼痛基本消失，且拔管无困难。迄今为止，这些患者均未发生肠梗阻或空肠扭转。
结论
超近端空肠造口术是一种安全可行的方法，是麦克尤恩式食管切除术后肠内营养支持的更好选择。
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