急性症状性食道切除术后腹膜的外科治疗 腹膜
Pamela Milito1, Stefano Siboni1, Andrea Lovece1
1Division of Emergency and General Surgery, IRCCS Policlinico San Donato, Milan, Italy.
Journal of laparoendoscopic & advanced surgical techniques. Part A
|September 24, 2025
概括
食道切除术后的腹膜 (PEDH) 是食道切除术后的一种罕见并发症. 及时诊断和紧急手术,通常是腹腔镜修复,对于管理急性症状和改善结果至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
背景情况:
- 食道切除术后的腹膜 (PEDH) 是食道切除术后的一种罕见但严重的并发症.
- 急性症状PEDH可以导致危及生命的疾病,如缺血或器官穿孔,需要紧急干预.
研究的目的:
- 报告一个第三级护理中心在管理急性症状PEDH方面的经验.
- 评估隔膜修复的方法,网格的使用,以及手术成功率.
主要方法:
- 对358名因癌症而接受食道切除术的患者 (2013-2023) 的回顾性分析.
- 早期PEDH的定义是术后30天内开始.
- 紧急手术患者急性症状如呼吸困难,卷积,缺血或穿孔.
主要成果:
- 11名患者 (3.1%) 患有需要紧急手术的PEDH; 5名患者患有早期PEDH.
- 在8例病例中,腹腔镜修复成功;在2例中,需要进行开放式手术.
- 死亡率为零,但观察到复发率为18%. 没有发现术前风险因素.
结论:
- PEDH是一种罕见的,严重的食道切除并发症,具有显著的发病率.
- 早期识别和迅速的手术干预对于患者的生存至关重要.
- laparoscopic 修复是高体积中心的首选; 修复策略应该是个性化的.
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