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首页> 外文期刊>Journal of International Medical Research >Fully robotic Ivor–Lewis esophagectomy (RAMIE4) for esophageal cancer after emergency surgery and ligation of the gastroduodenal artery
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Fully robotic Ivor–Lewis esophagectomy (RAMIE4) for esophageal cancer after emergency surgery and ligation of the gastroduodenal artery

机译：急诊外科手术和结扎十二指肠动脉后的全机器人Ivor-Lewis食管切除术（RAMIE4）用于食道癌

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We report a case of a 69-year-old patient with esophageal cancer and severe upper gastrointestinal bleeding during neoadjuvant radiochemotherapy who required mass transfusion followed by complex emergency procedures. Despite endoscopic stenting, the bleeding recurred, and thus emergency open surgery was required. Gastric wedge resection of the minor curvature necessitated by perforation caused by the endoscopic stent maneuver and duodenotomy with ligation of the gastroduodenal artery, as the cause of persistent intraluminal bleeding, were performed. The already prepared gastric conduit during the emergency operation did not become ischemic, even though the gastroduodenal artery, left gastric artery, and short gastric arteries were ligated during emergency surgery. After 2 months of recovery, a computed tomographic scan showed collateral perfusion of the conduit via the superior mesenteric artery. Therefore, a fully robotic (abdominal and thoracic) esophagectomy with pull-up of the gastric conduit was performed, with no post-surgical complications. The patient was discharged 10 days after the robotic esophagectomy. Six months after esophagectomy, the patient is in a good condition.
机译：我们报告了一例69岁的食管癌患者，在新辅助放化疗期间出现严重的上消化道出血，需要大量输注，然后进行复杂的紧急处理程序。尽管采用内窥镜支架置入术，但出血仍在复发，因此需要紧急开放手术。进行内镜支架操作和十二指肠切开术并结扎胃十二指肠动脉作为持续的腔内出血的原因而导致的穿孔所引起的胃小曲率的胃楔形切除。即使在急诊手术中结扎了胃十二指肠动脉，左胃动脉和胃短动脉，在急诊手术中已经准备好的胃导管也不会缺血。恢复2个月后，计算机断层扫描显示通过肠系膜上动脉对导管进行了侧支灌注。因此，进行了机械手（腹部和胸腔）食管切除术，并拔出了胃导管，没有术后并发症。机器人食管切除术后10天出院。食道切除术后六个月，患者情况良好。

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