Turner Megan, Baker Nicholas
Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
Thorac Surg Clin. 2024 Nov;34(4):415-425. doi: 10.1016/j.thorsurg.2024.05.004. Epub 2024 Jul 19.
This article outlines the anatomic and physiologic basis for gastric conduit ischemia and the range of its possible manifestations, from superficial mucosal ischemia to gross conduit necrosis. Methods by which these complications are suspected and ultimately diagnosed are discussed, focusing on clinical and laboratory signs as the harbingers and the use of imaging and endoscopy for confirmation. From there, management options are detailed based on the Esophagectomy Complications Consensus Group classification of esophageal leak and gastric necrosis. Finally, the short- and long-term implications of these complications are reviewed.
本文概述了胃代食管缺血的解剖学和生理学基础及其可能的表现范围，从浅表黏膜缺血到胃代食管广泛坏死。讨论了怀疑并最终诊断这些并发症的方法，重点关注作为先兆的临床和实验室体征以及用于确诊的影像学和内镜检查。在此基础上，根据食管切除术后并发症共识小组对食管漏和胃坏死的分类详细阐述了管理方案。最后，综述了这些并发症的短期和长期影响。
