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印度二级城市真实场景下食管切除术的短期结果

Short-Term Outcomes of Oesophagectomy in a Real-World Scenario from a Tier II City in India.

作者信息

Padhy Amita Sekhar, Nittala Rigved, Voleti Srikarthik, Chalapaka Chaitanya Raju

机构信息

Department of Surgical Oncology, Homi Bhabha Cancer Hospital & Research Centre, Visakhapatnam, 530053 Andhra Pradesh India.

出版信息

Indian J Surg Oncol. 2025 Apr;16(2):521-527. doi: 10.1007/s13193-024-01924-y. Epub 2024 Mar 20.

Abstract

This study evaluates short-term outcomes of oesophagectomy at a low-volume cancer hospital in Visakhapatnam, India. Fifteen patients who underwent oesophagectomy from 2020 to 2023 were analysed. The most common histology was squamous cell carcinoma. The mean age was 55 years and the majority were male. The common approaches used were open transhiatal and transthoracic oesophagectomy. The mean operative time was 9.5 h, and the mean hospital stay was 15.92 days. There were no perioperative deaths, but complications included pulmonary issues, vocal cord paralysis, anastomotic leaks, chyle leaks and wound infections. Higher volume centres tend to have better outcomes after oesophagectomy. However, factors other than volume like patient selection, ERAS (Enhanced Recovery After Surgery) protocols, specialized critical care and trained multidisciplinary teams also impact outcomes. At our centre, though a low-volume hospital, proper patient selection, prehabilitation and a collaborative team approach helped achieve acceptable results. We recommend developing consensus on defining low- and high-volume centres for oesophagectomy in the Indian context, based on disease burden, resources and constraints. Overall, there is a lack of Indian data comparing outcomes between low and high-volume centres for oesophagectomy.

摘要

本研究评估了印度维沙卡帕特南一家低容量癌症医院食管癌切除术的短期疗效。分析了2020年至2023年期间接受食管癌切除术的15例患者。最常见的组织学类型为鳞状细胞癌。平均年龄为55岁,大多数为男性。常用的手术方法为开放经裂孔和经胸食管癌切除术。平均手术时间为9.5小时,平均住院时间为15.92天。围手术期无死亡病例,但并发症包括肺部问题、声带麻痹、吻合口漏、乳糜漏和伤口感染。高容量中心食管癌切除术后的疗效往往更好。然而,除了手术量之外,患者选择、加速康复外科(ERAS)方案、专业重症监护和训练有素的多学科团队等因素也会影响疗效。在我们中心,尽管是一家低容量医院,但通过合理的患者选择、术前康复和协作团队方法,取得了可接受的结果。我们建议根据疾病负担、资源和限制,就印度背景下食管癌切除术低容量和高容量中心的定义达成共识。总体而言,印度缺乏比较食管癌切除术低容量和高容量中心疗效的数据。

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Anaesthesia during oesophagectomy.食管癌切除术期间的麻醉
J Thorac Dis. 2017 Jul;9(Suppl 8):S705-S712. doi: 10.21037/jtd.2017.03.153.

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