最少侵入性食道切除程序的演变 - - 有效的并发症管理是关键
Çağatay Çetinkaya1, Zeynep Bilgi2, Sezer Aslan3
1Department of Thoracic Surgery, Uskudar University, School of Medicine, İstanbul, Turkey.
概括
最少侵入性食管切除术 (MIE) 改善了手术结果,随着时间的推移,成功率增加和死亡率降低. 经验增强了MIE完成和胸内缩偏好,尽管患病率相似.
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:
- 消化管切除术是一种高发病率的瘤手术.
- 与开放式手术相比,微创手术对食道切除术具有显著的好处.
研究的目的:
- 为了评估完全微创性食道切除术的早期外科结果.
- 评估在外科手术期间管理中积累的经验对结果的影响.
主要方法:
- 对167名中/远食道癌患者进行食道切除和胃管道建设的前性数据收集 (2004-2021年).
- 根据手术方法,患者被分为三组:开放式手术,采用微创手术和例行微创手术.
- 评估人口统计数据,新辅助治疗,手术细节和外科手术期间的死亡率/发病率.
主要成果:
- 随着时间的推移,成功的完全微创食道切除术的可能性和对胸内解剖的偏好显著增加 (p < 0.0001).
- 最新的队列 (常规MIE) 显示90天死亡率显著下降.
- 主要发病率在所有组中保持稳定,尽管最近的队列中患者人群年龄较大.
结论:
- 积累的经验有助于成功完成微创食道切除术.
- 胸内解剖成为首选的方法,有助于改善外科手术后期的结果.
- 随着时间的推移,手术死亡率的降低归因于技术进步和改善的并发症管理.
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