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首页> 美国卫生研究院文献>Journal of Zhejiang University. Science. B >Clinical analysis of minimally invasive McKeown esophagectomy in a single center by a single medical group
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Clinical analysis of minimally invasive McKeown esophagectomy in a single center by a single medical group

机译：单个医疗小组在单个中心进行微创McKeown食管切除术的临床分析

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Objective: McKeown esophagectomy followed by cervical and abdominal procedures has been commonly used for invasive esophageal carcinoma. This minimally-invasive operative procedure in the lateral prone position has been considered to be the most appropriate method. We describe our experiences in minimally invasive McKeown esophagectomy (MIME) for esophageal cancer. Methods: Between March 2016 and February 2018, a total of 82 patients underwent MIME by a single group in our department (a single center). All procedure, operation, oncology, and complication data were reviewed. Results: All MIME procedures were completed successfully, with no conversions to open surgery. The median operative time was 260 min, and median blood loss was 100 ml. The average number of total harvested lymph nodes was 20.1 in the chest and 13.5 in the abdomen. There were no deaths within 30 postoperative days. Twenty cases (24.4%) developed postoperative complications, including anastomotic leak in 4 (4.9%), single lateral recurrent nerve palsy in 4 (4.9%), bilateral recurrent nerve palsy in 1 (1.2%), pulmonary problems in 3 (3.7%), chyle leak in 1 (1.2%), and other complications in 7 (including pleural effusions in 4, incomplete ileus in 2, and neck incision infection in 1; 8.54%). Average postoperative hospitalization time was 12 d. Blood loss, operation time, morbidity rate, and the number of harvested lymph nodes were analyzed by evaluating learning curves in different periods. Significant differences were found in operative time (P=0.006), postoperative hospitalization days (P=0.015), total harvested lymph nodes (P=0.003), harvested thoracic lymph nodes (P=0.006), and harvested abdominal lymph nodes (P=0.022) among different periods. Conclusions: Surgical outcomes following MIME for esophageal cancer are safe and acceptable. The MIME procedure for stages I and II could be performed proficiently and reached an experience plateau after approximately 25 cases.
机译：目的：McKeown食管切除术随后进行宫颈和腹部手术已广泛用于浸润性食管癌。这种侧卧位微创手术程序被认为是最合适的方法。我们描述了我们在食管癌微创McKeown食管切除术（MIME）中的经验。方法：在2016年3月至2018年2月之间，我们部门（一个中心）的一个小组对总共82例患者进行了MIME检查。审查了所有程序，手术，肿瘤学和并发症数据。结果：所有MIME程序均已成功完成，没有转换为开放式手术。中位手术时间为260分钟，中位失血量为100毫升。总共收集到的淋巴结的平均数在胸部为20.1，在腹部为13.5。术后30天内无死亡病例。 20例（24.4％）发生了术后并发症，包括吻合口漏4例（4.9％），单侧复发性神经麻痹4例（4.9％），双侧复发性神经麻痹1例（1.2％），肺部疾病3例（3.7％） ），乳糜漏1例（1.2％），其他并发症7例（包括胸腔积液4例，不完全性肠梗阻2例和颈部切口感染1例; 8.54％）。术后平均住院时间为12 d。通过评估不同时期的学习曲线，分析失血量，手术时间，发病率和收集的淋巴结数目。在手术时间（P = 0.006），术后住院天数（P = 0.015），总收获淋巴结（P = 0.003），胸腔淋巴结（P = 0.006）和腹部腹腔淋巴结（P = 0.022）。结论：MIME后的食管癌手术结局是安全且可以接受的。 I和II期的MIME程序可以熟练执行，大约25例后达到经验平台。

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