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首页> 外文期刊>Surgical Endoscopy >Minimally invasive esophagectomy with and without gastric ischemic conditioning
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Minimally invasive esophagectomy with and without gastric ischemic conditioning

机译：有无胃缺血调节的微创食管切除术

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Background Esophagectomy can be associated with significant morbidity such as leaks and strictures. Preoperative gastric ischemic conditioning is a concept aimed at inducing an ischemic insult to the gastric fundus and cardia prior to esophagectomy, thus leading to improvement of gastric perfusion. Methods This retrospective study compared outcome data from 81 patients who underwent esophagectomy after laparoscopic gastric ischemic conditioning with that from 71 patients who underwent esophagectomy without conditioning. Gastric ischemic conditioning consisted of laparoscopic division of the left gastric vessels ± the short gastric vessels. The time interval from gastric ischemic conditioning to esophagectomy ranged from 2 to 75 days. Main outcome measures included demographics, mean time interval between staging and esophagectomy, and the rate of leaks and strictures following esophagectomy. Results The two groups were comparable with respect to gender and age. In the gastric ischemic conditioning procedures, there were no conversions; the mean operative time was 57 ± 15 min, the mean length of hospital stay was 1.0 ± 1.1 days, and the rate of postoperative complications was 3.7%. The mean time interval between gastric ischemic conditioning and esophagectomy was 6.0 ± 5.4 days. There were no significant differences in the leak rate (11.1% for conditioning vs. 8.5% without conditioning) or stricture rate (29.6% for conditioning vs. 25.3% without conditioning) between the two groups. Conclusions Laparoscopic gastric ischemic conditioning is feasible and safe. However, the use of gastric ischemic conditioning in this study did not alter the clinical rate of postoperative leaks and strictures.
机译：背景食管切除术可能与诸如漏气和狭窄等重大疾病相关。术前胃缺血调节是一个概念，旨在在食管切除术之前引起对胃底和card门的缺血性损伤，从而改善胃灌注。方法这项回顾性研究比较了81例经腹腔镜胃缺血治疗后接受食管切除术的患者和71例未经条件进行食管切除术患者的结局数据。胃缺血性调理包括腹腔镜分割左胃血管±短胃血管。从胃缺血适应到食管切除术的时间间隔为2至75天。主要结局指标包括人口统计学，分期和食管切除术之间的平均时间间隔，以及食管切除术后渗漏和狭窄的发生率。结果两组在性别和年龄方面均具有可比性。在胃缺血性调节程序中，没有转化。平均手术时间为57±15分钟，平均住院时间为1.0±1.1天，术后并发症发生率为3.7％。胃缺血适应和食管切除术之间的平均时间间隔为6.0±5.4天。两组之间的泄漏率（有条件的泄漏率为11.1％，无条件的泄漏率为8.5％）或狭窄率（有条件的泄漏率为29.6％，无条件的泄漏率为25.3％）无显着差异。结论腹腔镜胃缺血调理可行，安全。但是，在本研究中使用胃缺血性调理并不能改变术后渗漏和狭窄的临床发生率。

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