[1]张勇超** 赵明海 任晋军 李柳 张永磊.食管分层离断法在腹腔镜辅助食管胃结合部癌手术中的应用[J].中国微创外科杂志,2021,01(3):205-209.
 Zhang Yongchao,Zhao Minghai,Ren Jinjun,et al.Application of Esophagus Transection in Layers in Laparoscopicassisted Radical Resection for Esophagogastric Junction Carcinoma[J].Chinese Journal of Minimally Invasive Surgery,2021,01(3):205-209.
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食管分层离断法在腹腔镜辅助食管胃结合部癌手术中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年3期
页码:
205-209
栏目:
临床论著
出版日期:
2021-04-01

文章信息/Info

Title:
Application of Esophagus Transection in Layers in Laparoscopicassisted Radical Resection for Esophagogastric Junction Carcinoma
作者:
张勇超** 赵明海 任晋军 李柳 张永磊
(郑州大学附属肿瘤医院河南省肿瘤医院普外科,郑州450008)
Author(s):
Zhang Yongchao Zhao Minghai Ren Jinjun et al.
Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
关键词:
食管胃结合部癌腹腔镜食管分层离断食管空肠吻合术
Keywords:
Esophagogastric junction carcinomaLaparoscopyEsophagus transection in layersEsophagojejunostomy
文献标志码:
A
摘要:
目的探讨食管分层离断法在腹腔镜辅助食管胃结合部癌手术中应用的可行性及安全性。方法回顾性分析2016年5月~2019年11月422例食管胃结合部癌行腹腔镜辅助根治性全胃切除术的临床资料,2018年2月前203例采用常规方法吻合(传统组),之后219例采用食管分层离断法进行食管空肠吻合(分层组)。比较2组手术时间、食管离断及抵钉座放置时间、术后吻合口并发症发生率及术后住院时间等指标。结果2组手术均顺利完成,均随访1年。分层组术后吻合口并发症发生率[0.5%(1/219)]低于传统组[5.9%(12/203)](χ2=10.499,P=0.001)。2组手术时间、食管离断及抵钉座放置时间、术中出血量、术后首次排气时间、开始进食流质饮食时间、术后住院时间差异均无统计学意义(P>0.05)。结论在腹腔镜辅助食管胃结合部癌手术中应用食管分层离断法行食管空肠吻合,可明显降低术后吻合口并发症的发生,临床效果满意。
Abstract:
ObjectiveTo explore the feasibility and safety of esophagus transection in layers in laparoscopicassisted radical resection for esophagogastric junction carcinoma. MethodsA retrospective analysis was performed on the clinical data of 422 patients with esophagogastric junction carcinoma who underwent laparoscopicassisted radical total gastrectomy in our hospital between May 2016 and November 2019. Esophagojejunostomy was performed by routine method in 203 cases before February 2018 (traditional group), after that, esophagus transection in layers for anastomosis was used in 219 cases (layering group). Data analysis included operating time, time of esophagus transection and anvil placement, the incidence of postoperative anastomotic complications, postoperative hospitalization time, and so on.ResultsLaparoscopicassisted radical resection for esophagogastric junction carcinoma was successfully performed in all the patients. All of them were followed up for 1 year. The incidence of postoperative anastomotic complications in layering group [0.5% (1/219)] was significantly lower than that in traditional group [5.9% (12/203), χ2=10499, P=0.001]. There were no statistically significant differences between the two groups in operation time, time of esophagus transection and anvil placement, intraoperative blood loss, time to first flatus postoperatively, time for initial fluid diet intake postoperatively, postoperative hospitalization time (P>0.05).ConclusionThe application of esophagus transection in layers in laparoscopicassisted radical resection for esophagogastric junction carcinoma can obviously decrease the occurrence of postoperative anastomotic complications with satisfactory clinical results.

参考文献/References:

[1]Zhao Y,Zhang J,Yang D,et al.Feasibility of laparoscopic total gastrectomy for advanced Siewert type Ⅱ and type Ⅲ esophagogastric junction carcinoma:a propensity scorematched casecontrol study.Asian J Surg,2019,42(8):805-813.
[2]Zhang P,Zhang X,Xue H.Longterm results of handassisted laparoscopic gastrectomy for advanced Siewert type II and type III esophagogastric junction adenocarcinoma.Int J Surg,2018,53:201-205.
[3]陈秋贤,蔡丽生,方顺勇,等.腹腔镜胃癌根治性全胃切除术后外科并发症的ClavienDindo分级及危险因素分析.中国微创外科杂志,2017,17(2):120-125.
[4]Goh PM,Khan AZ,So JB,et al.Early experience with laparoscopic radical gastrectomy for advanced gastric cancer.Surg Laparosc Endosc Percutan Tech,2001,11(2):83-87.
[5]胡建昆,张维汉.重视胃癌术后吻合口相关并发症的防治.中华消化外科杂志,2020,19(9):946-950.
[6]Chen XZ,Li YY,Hu JK,et al.Spread and development of laparoscopic surgery for gastric tumors in mainland China: initial experiences. Hepatogastroenterology,2012,59(114):654-658.
[7]Ramagem CA,Linhares M,Lacerda CF,et al.Comparison of laparoscopic total gastrectomy and laparotomic total gastrectomy for gastric cancer.Arq Bras Cir Dig,2015,28(1):65-69.
[8]Lu Y,Jiang B,Liu T.Laparoscopic versus open total gastrectomy for advanced proximal gastric carcinoma: a matched pair analysis.J Buon,2016,21(4):903-908.
[9]Huang CM,Lv CB,Lin JX,et al.Laparoscopicassisted versus open total gastrectomy for Siewert type Ⅱ and Ⅲ esophagogastric junction carcinoma:a propensity scorematched casecontrol study.Surg Endosc,2017,31(9):3495-3503.
[10]Chen XZ,Wang SY,Wang YS,et al.Comparisons of shortterm and survival outcomes of laparoscopyassisted versus open total gastrectomy for gastric cancer patients.Oncotarget,2017,8(32):52366-52380.
[11]Shu B,Lei S,Li F,et al.Laparoscopic total gastrectomy compared with open resection for gastric carcinoma:a casematched study with longterm followup.J Buon,2016,21(1):101-107.
[12]Lee Y,Min SH,Park KB,et al.Longterm outcomes of laparoscopic versus open transhiatal approach for the treatment of esophagogastric junction cancer.J Gastric Cancer,2019,19(1):62-71.
[13]李敏哲,沈荐,杜燕夫,等.进展期胃癌腹腔镜辅助与开腹全胃D2根治术临床疗效的比较.中国微创外科杂志,2017,17(7):589-593.
[14]Li Z,Dong J,Huang Q,et al.Comparison of three digestive tract reconstruction methods for the treatment of Siewert Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction:a prospective,randomized controlled study.World J Surg Oncol,2019,17(1):209.
[15]Hlscher AH,Law S.Esophagogastric junction adenocarcinomas:individualization of resection with special considerations for Siewert type Ⅱ,and Nishi types EG,E=G and GE cancers.Gastric Cancer,2020,23(1):3-9.
[16]Niclauss N,Jung MK,Chevallay M,et al.Minimal length of proximal resection margin in adenocarcinoma of the esophagogastric junction:a systematic review of the literature.Updates Surg,2019,71(3):401-409.

备注/Memo

备注/Memo:
基金项目:河南省留学人员科技活动项目择优资助经费(2017-9)**通讯作者,Email:zyczhang1977@163.com
更新日期/Last Update: 2021-06-09