在患有食道泄漏高风险的患者中,食道切除术前通过皮肤血管栓塞进行胃预调
Kaitlin C Bevers1, Marisa Sewell1, Matthew J Bott1
1Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
概括
在高危患者中,使用血管栓塞的穿皮胃预调可以安全地改善胃管输液在食道切除前. 这种新的方法在减少泄漏和狭窄症等关键性解剖学并发症方面表现有前途.
科学领域:
- 干预性放射学 干预性放射学
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 解剖管泄漏和狭窄症是食道切除术后的严重并发症,通常与胃管 perfusion 不良有关.
- 手术胃预调是一种选择,但涉及额外的手术和痕,可能会使未来的手术复杂化.
研究的目的:
- 通过血管栓塞来评估穿皮胃预调的安全性和可行性.
- 在高风险患者中,在食道切除术前增强胃管 perfusion.
主要方法:
- 图像引导的,左胃和短胃动脉的超选择性血管栓塞在门诊基础上进行.
- 在等待食道切除手术的17名高危患者接受了这种预先调节手术.
- 评估了手术期间的绿色氨酸输液和手术后的结果.
主要成果:
- 在皮预先调节过程中或之后没有报告任何并发症.
- 所有13名进行食道切除的患者都表现出适当的手术内胃管 perfusion.
- 在研究队列中没有观察到静脉狭窄或泄漏的情况.
结论:
- 通过血管栓塞进行穿皮胃预调是一种安全且可行的方法,用于改善高风险食道切除术患者的胃管输液.
- 这种技术可以在不推迟手术的情况下进行,并可能有助于预防静脉结节并发症.
- 建议进行进一步的研究,以验证预先条件的有效性,以优化导管和减少食道切除术并发症.
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