Bartels H, Thorban S, Siewert J R
Department of Surgery, Klinikum rechts der Isar, Technischen Universität München, Germany.
Br J Surg. 1993 Sep;80(9):1141-4. doi: 10.1002/bjs.1800800924.
In a prospective randomized trial the clinical results after transhiatal oesophagectomy with reconstruction in the anterior mediastinum (51 patients) or posterior mediastinum (45 patients) were compared. There were no differences in age, preoperative risk factors, tumour stage and local (surgical) complications between the two groups. However, reconstruction in the posterior mediastinum was associated with significantly fewer days spent in the intensive therapy unit (9 versus 14), fewer cardiopulmonary complications (13 versus 25 per cent) and lower mortality (30-day mortality rate 2 versus 6 per cent; hospital mortality rate 4 versus 10 per cent). These data show superiority of reconstruction in the posterior mediastinum after transhiatal oesophagectomy. This route is strongly recommended, particularly for patients with cardiopulmonary risk factors.
在一项前瞻性随机试验中，对经裂孔食管切除术并在前纵隔（51例患者）或后纵隔（45例患者）进行重建后的临床结果进行了比较。两组在年龄、术前危险因素、肿瘤分期和局部（手术）并发症方面无差异。然而，后纵隔重建与重症监护病房住院天数显著减少（9天对14天）、心肺并发症较少（13%对25%）以及死亡率较低（30天死亡率2%对6%；医院死亡率4%对10%）相关。这些数据表明经裂孔食管切除术后后纵隔重建具有优越性。强烈推荐此路径，特别是对于有心肺危险因素的患者。
