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食管外科的历史。

The history of esophageal surgery.

机构信息

First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.

Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Acta Chir Belg. 2023 Dec;123(6):712-723. doi: 10.1080/00015458.2023.2254604. Epub 2023 Sep 5.

Abstract

BACKGROUND

Esophageal surgery has always been considered extremely demanding, given the surgical experience and skills required, due to the anatomic location of the esophagus as well as the impact of such extensive operations on patients' homeostasis. The intention of the present study is to review all historical time points of esophageal surgery, from its inception to the modern era of minimally invasive esophageal surgery.

METHODS

The first clear description of esophageal surgery is dated back to 1738, in an attempt to remove a foreign body from the thoracic esophagus. However, the high morbidity and mortality rates of esophageal surgical operations led to the invention and application of less invasive surgical procedures.

RESULTS

Esophageal surgery has evolved from extensive surgical operations to minimally invasive esophagectomies, aiming exclusively to reduce perioperative morbidity and mortality, while maintaining surgical effectiveness. Despite the fact that benign esophageal pathologies were the main stimulus for this evolution, minimally invasive esophageal surgery is now applied even in patients with esophageal cancer, with outcomes comparable to those of traditional surgical approaches.

CONCLUSION

It would be interesting to see how all these new surgical techniques may evolve, altering further the current status of esophageal surgery in the future.

摘要

背景

由于食管的解剖位置以及此类广泛手术对患者内稳态的影响,食管手术一直被认为极具挑战性,需要丰富的手术经验和技能。本研究旨在回顾食管外科手术的所有历史阶段,从起源到现代微创食管外科时代。

方法

对食管手术的首次明确描述可追溯至 1738 年,当时试图从胸段食管取出异物。然而,食管外科手术的高发病率和死亡率导致了创伤更小的手术方法的发明和应用。

结果

食管外科手术已从广泛的手术演变为微创食管切除术,其唯一目的是降低围手术期发病率和死亡率,同时保持手术效果。尽管良性食管病变是这种演变的主要刺激因素,但微创食管切除术现在甚至应用于食管癌患者,其结果与传统手术方法相当。

结论

了解所有这些新技术可能如何演变,以及它们将如何进一步改变未来食管外科的现状将是一件有趣的事。

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