开放式和腹腔镜辅助食道置换手术的短期和中期结果
Ahmed Maher1, Paolo De Coppi2, Simon Blackburn3
1Great Ormond Street Hospital for Children, London, United Kingdom; Assiut University, Assiut, Egypt.
Journal of pediatric surgery
|November 28, 2023
概括
开放式和腹腔镜辅助食道置换手术在儿童中显示出类似的短期结果. 造成性损伤增加了收缩风险,需要更多的扩张. 这两种手术对于食道置换都是有效的.
科学领域:
- 儿科手术 儿科手术
- 胃肠道手术 胃肠道手术
- 最少侵入性的手术
背景情况:
- 食道置换手术是针对患有食道缩,致病损伤或其他疾病的儿科患者的复杂手术.
- 开放性食道置换 (OAR) 和腹腔镜辅助食道置换 (LAR) 都被使用,结果各不相同.
- 了解比较疗效和并发症率对于手术决策至关重要.
研究的目的:
- 在儿童群体中,比较开放式与腹腔镜辅助食道置换手术的短期和中期结果.
- 识别影响并发症发生率的因素,特别是狭窄形成.
- 评估这两种手术方法的安全性和有效性.
主要方法:
- 在2002年至2021年期间接受OAR或LAR的71名儿童的回顾性审查.
- 数据收集包括人口统计,早期并发症,狭窄形成,需要扩张和死亡率.
- 使用GraphPad Prism进行统计分析,以中位数 (IQR) 呈现数据.
主要成果:
- 71名儿童接受了食道置换,其中51名 (71.8%) 是LAR. 最常见的病理是食道缩 (n=50).
- 早期术后死亡率为2.8%. 在LAR和OAR之间,并发症的发生率 (解剖管泄漏,多流,早期收缩) 是可比的.
- 患有腐蚀性损伤的患者出现需要扩张的狭窄率较高 (60%对食道缩的30%,p=0.05).
结论:
- 开放式和腹腔镜辅助食道置换手术在儿童中显示出可比的短期和中期结果.
- 造成的损伤是食道置换后解剖狭窄形成的重要危险因素.
- 这两种手术技术都是可行的选择,但要仔细考虑特定的病理,如伤.
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