老年患者的最小侵入性艾弗·易斯食道切除术:一个多中心的回顾性匹配队列研究
Giovanni Capovilla1, Eren Uzun2, Alessia Scarton1
1Department of Surgery, Oncology and Gastroenterology (DiSCOG), Padova University Hospital, Padova, Italy.
最少侵入性食管切除术显著减少了手术后的并发症,包括肺部问题,并缩短了老年患者 (≥75岁) 的住院时间. 这种方法的好处与接受手术的年轻患者所看到的好处相当.
科学领域:
- 手术瘤学手术瘤学
- 老年医学 老年医学
- 胸部外科手术 胸部外科手术
背景情况:
- 至少侵入性食道切除术 (MIE) 对一般人群来说显示出优势,而不是开放式手术.
- 对接受食道切除术的老年患者MIE益处的数据有限.
- 老年患者可能不会像年轻人一样从MIE中获得相同的优势.
研究的目的:
- 评估微创食道切除术 (MIE) 或机器人辅助微创食道切除术 (RAMIE) 是否能降低老年患者 (≥75岁) 的术后发病率.
- 为了比较MIE/RAMIE与老年患者的开放食道切除术的结果.
- 评估MIE/RAMIE福利是否延伸到老年人群.
主要方法:
- 来自梅因茨大学医院和帕多瓦大学医院的食道切除患者 (2016-2021) 的回顾性分析.
- 在接受开放性或MIE/RAMIE食道切除术的老年 (≥75岁) 患者之间比较临床特征和术后结果.
- 作为对照组,对75岁以下的患者进行了1比1匹配的比较和评估.
主要成果:
- 接受MIE/RAMIE的老年患者的整体发病率较低 (39.7%与62.7%,p=0.005),肺部并发症较少 (32.8%与56.9%,p=0.003).
- 在老年患者中,MIE/RAMIE与较短的住院时间 (13 vs. 18天,p=0.03) 有关.
- 在接受MIE/RAMIE的75岁以下患者中观察到类似的发病率和肺部并发症的减少.
结论:
- 最少侵入性食道切除术 (MIE/RAMIE) 改善了老年患者的术后过程.
- 该程序显著降低了术后并发症的总体发生率,特别是肺部并发症.
- 在食道切除术中,微创方法的好处延伸到老年人群.
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