最少侵入性食道切除术的手术持续时间对术后结果的影响
Haley I Tupper1,2, Belia O Roybal3, Riley W Jackson4
1Division of General Surgery, Department of Surgery, University of California, Los Angeles, CA, United States.
Frontiers in surgery
|March 5, 2024
概括
在食道癌的微创性食道切除术 (MIE) 中,延长的手术时间与更高的并发症和死亡率有关. 提高手术效率可能会在这种高风险的手术中改善患者的结果.
科学领域:
- 手术瘤学手术瘤学
- 胸部外科手术 胸部外科手术
- 最少侵入性的手术
背景情况:
- 食道切除术是食道癌的关键治疗方法,但具有显著的发病率.
- 最少侵入性食道切除术 (MIE) 可能特别受到长时间的手术时间的影响,这会影响诸如解静脉泄漏和导管 perfusion.
- 运营时间对MIE结果的确切影响仍然在很大程度上是未知的.
研究的目的:
- 为了研究手术时间和术后结果之间的关联,在接受食道癌微创性食道切除术的患者.
- 确定长时间的手术时间是否是MIE后特定并发症,再入院或死亡的风险因素.
主要方法:
- 一项多中心回顾性队列研究分析了2010年至2021年期间接受MIE的297名食道癌患者的数据.
- 收集了患者的人口统计,并发症和治疗变量.
- 使用多变量后勤回归和子组分析来评估手术时间和结果之间的关系,包括并发症,再入院和生存.
主要成果:
- 对于MIE的中位数手术持续时间是4.8小时.
- 患有静脉泄漏 (5.1%) 或1年死亡率的患者的手术时间显着更长 (分别为6.3小时和5.3小时).
- 每增加一小时的手术时间都会增加39%的静脉漏的几率和19%的1年死亡率.
结论:
- 操作效率是一个可修改的因素,可能会显著影响患者在微创性食道切除术后的结果.
- 向减少手术时间可能是一个关键策略,以改善经历MIE的食道癌症患者的结果.
- 进一步研究优化手术效率是有必要的.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
84
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
84
Endoscopic Procedures I: Esophagogastroduodenoscopy
115
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
115
Esophageal Perforation-II: Clinical Manifestations and Management
63
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
63
Endoscopic Studies I: Bronchoscopy and Thoracoscopy
194
Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
194


