最少侵入性食道切除术后的解剖阻塞
Paul L Feingold1, Darren S Bryan1, John Kuckelman1
1Division of Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
The Annals of thoracic surgery
|May 27, 2023
概括
最少侵入性食道切除术 (MIE) 可能导致静脉狭窄. 在MIE后的早期扩张增加了重复扩张的需要,突出了管理这些狭窄的时间的重要性.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 胸部外科手术 胸部外科手术
背景情况:
- 最少侵入性食管切除术 (MIE) 改善了结果,但与静脉狭窄症有关.
- 在MIE之后的耐火性狭窄并未得到充分理解,特别是在北美.
- 解剖管狭窄是一种已知的并发症,需要进行干预.
研究的目的:
- 为了调查MIE后的静脉狭窄的发生率和风险因素.
- 分析MIE患者的扩张率和结果.
- 为了确定与MIE后的耐火性静脉狭窄症相关的因素.
主要方法:
- 在2015年至2019年期间接受MIE的391名患者的回顾性审查.
- 分析解口扩张率和患者特异性风险因素.
- 单变量和多变量统计分析以确定与狭窄发育和扩张频率的关联.
主要成果:
- 34.5%的患者需要431次扩张;平均每患者3.2次扩张.
- 与两场MIE相比,三场MIE与更高的扩张率有关,但考虑到外科医生的变化后,这并不重要.
- 手术后100天内扩张与随后扩张的更高需求相关 (2.0 vs 0.6扩张/年).
结论:
- 一个三领域的MIE方法可能与增加的重复延迟有关.
- oesophagectomy 和初始扩张之间的间隔是重复干预的关键因素.
- 及时干预至关重要,以最大限度地减少MIE后道狭窄的重复扩张.
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