在中间视镜辅助的激进食道切除术中,左主和右辅助操作模式
Peisong Yuan1, Weipeng Hu1, Zheng Liu1
1Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China.
Surgical endoscopy
|August 29, 2023
概括
一种经过修改的介质镜辅助转性食道切除术 (MATHE) 简化了该程序,减少了手术时间和血液损失. 这种改进的技术还提高了食道癌患者的上部中枢淋巴结解剖率.
科学领域:
- 手术瘤学手术瘤学
- 最少侵入性的手术
- 食道癌治疗方法 食道癌治疗方法
背景情况:
- 介质显微镜辅助的横腔食道切除术 (MATHE) 是最不侵入性的食道切除术,但很难普及.
- 开发了一种新的 MATHE 方法来改善可视化和简化程序.
研究的目的:
- 与经典方法相比,评估修改后的MATHE技术的有效性和安全性.
- 评估修改后的MATHE对手术结果和淋巴结解剖的影响.
主要方法:
- 80名食道癌患者被分为对照组 (经典的MATHE) 和研究组 (修改的MATHE).
- 测量的关键结果包括手术时间,血液损失,输血量和并发症率 (肺部感染,RLN损伤,胸,解剖器泄漏).
- 在不同组之间比较了上半叶淋巴结解剖率.
主要成果:
- 修改后的MATHE组的操作时间显著缩短 (271.78分 vs. 322.90分) 和血液损失减少 (48.63毫升 vs. 68.97毫升).
- 左侧腹腔淋巴结 (左侧腹腔淋巴结) 4L) 解剖率在修改后的MATHE组显著更高 (88.24%对比24.14%).
- 无显著的差异被观察到的解剖管泄漏,肺部并发症,或复发性喉神经 (RLNs) 损伤率.
结论:
- 修改后的MATHE在技术上比经典的MATHE更简单,更容易执行.
- 修改后的方法在减少手术时间,手术期间流血和改善淋巴结解剖方面提供了显著的优势.
- 修改后的MATHE代表了对最小侵入性食道切除术的优越替代方案.
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