获得的非恶性气道食道:40年来改变原因和手术方法
Guillaume Fadel1, Olaf Mercier1, Nicolas Leymarie2
1Department of Thoracic Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, Université Paris-Saclay, 133 Avenue de la Résistance, 92350, Le Plessis Robinson, France.
Annals of surgery
|March 6, 2025
概括
获得的非恶性气管食道囊 (ANM-TEF) 的原因已经从输入管转向喉和食道手术. 尽管组织损伤增加,但由于片重建等先进技术,手术结果保持稳定.
科学领域:
- 胸部外科手术 胸部外科手术
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术瘤学手术瘤学
背景情况:
- 获得的非恶性气管食道 (ANM-TEF) 是一种罕见的,危及生命的疾病,管理方案不完善.
- 关于ANM-TEF原因,手术干预和患者结局的历史数据有限.
研究的目的:
- 分析ANM-TEF在四十年 (1981-2022) 的演变.
- 为了比较两个不同的时期 (1981-2007年和2008-2022年) 中的病因因素,手术治疗和患者结果的变化.
主要方法:
- 90名连续接受ANM-TEF手术修复的患者的回顾性分析.
- 早期 (1981-2007年,n=48) 和最近 (2008-2022年,n=42) 期患者队列的比较.
- 原因的评估,手术技术,片重建的使用,以及术后的结果.
主要成果:
- 由于ANM-TEF的原因,输管减少了 (91.7%至21.4%),而喉癌治疗和食道手术增加了.
- 由于局部组织损伤的增加,皮带穿孔片的使用量显著增加 (2.1%至66.7%).
- 最初的塞闭合在86.6%的患者中是成功的,90天死亡率为13.3%,没有显著的群体差异.
结论:
- 喉和食道手术现在是ANM-TEF的主要原因,取代了输管.
- 尽管最近的病例中局部组织损伤更严重,但手术结果一直保持不变.
- 手术技术的进步,包括皮片重建,对于成功的ANM-TEF管理至关重要.
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