esophagogastrostomy

食管胃吻合术
  • 文章类型: Review
    食管穿孔或破裂的治疗是复杂和有争议的,尤其是在先进的情况下。事实上,人们普遍认为,这种疾病必须根据位置单独治疗,破裂或穿孔的原因和临床特征。我们部门收治了一个非常罕见的病例,5天前,他被运行中的空气压缩机的高压气体炸伤,导致胸段食管长期纵向破裂。尽管患者同时患有脓胸和纵隔炎,他的情况很严重,脓胸的清创和脱屑仍在实施,随后在同一时期进行了左胸食管切除术和左颈入路食管胃吻合术。病人最终取得了良好的结果。
    Treatment of esophageal perforation or rupture is complicated and controversial, especially in advanced cases. In fact, it is generally accepted that this disease must be treated individually according to the location, causes and clinical features of rupture or perforation. A very rare case was admitted to our department, who was injured 5 days ago by high-pressure gas of a running air compressor and resulted in a long-term longitudinal rupture of the thoracic esophagus. Although the patient suffered from empyema and mediastinitis at the same time, and his condition was very serious, the debridement and desquamation of empyema were still implemented, followed by left thoracic esophagectomy and left neck approach esophagogastrostomy in the same period successfully. The patient got a good result finally.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:已经发表了比较近端胃切除术后几种重建方法的其他研究;值得注意的是,有必要从现有的循证文献中更新系统综述和荟萃分析.
    目的:为了扩大目前关于可行性和安全性的知识,并分析近端胃切除术后几种重建技术的术后结果。
    方法:PubMed,谷歌学者,搜索Medline数据库寻找原始研究,选择了1966年至2019年之间发表的有关近端胃切除术的各种重建技术的相关文献。评估重建技术的术后结果和并发症。使用Rev-Man5.0进行Meta分析。共有29项研究调查了双束重建术后的结果,空肠囊插入,空肠间置术,食管胃吻合术,最终选择双皮瓣重建进行定量分析。
    结果:用于双道重建的反流性食管炎的合并发生率,空肠囊插入,空肠间置食管胃吻合术,双皮瓣重建占8.6%,13.8%,13.8%,19.3%,和8.9%。Meta分析显示,与JPI组相比,JI组的住院时间减少(异质性:Chi2=1.34,df=1(P=0.25);I2=26%,总效应检验:Z=2.22(P=0.03)。JI和EG在住院时间上也有显着差异,具有异质性:Chi2=1.40,df=3(P=0.71);I2=0%,总效应检验:Z=5.04(P<0.00001)。与JI组相比,EG组的手术时间更短(异质性:Chi2=31.09,df=5(P<0.00001);I2=84%,综合效果检验:Z=32.35(P<0.00001)。
    结论:尽管目前的重建技术具有优异的抗反流功效,最优的重建方法还有待确定。经证实双皮瓣重建可降低并发症发生率,但是DTR,JI,JPI,EG组吻合口漏并发症发生率较高,吻合口狭窄,和残留的食物。在荟萃分析结果中,JI之间的并发症,JPI,和EG具有可比性,但EG组显示出更好的手术时间,失血,和住院时间。
    BACKGROUND: Additional studies comparing several reconstruction methods after proximal gastrectomy have been published; of note, it is necessary to update systematic reviews and meta-analysis from the current evidence-based literature.
    OBJECTIVE: To expand the current knowledge on feasibility and safety, and also to analyze postoperative outcomes of several reconstructive techniques after proximal gastrectomy.
    METHODS: PubMed, Google Scholar, and Medline databases were searched for original studies, and relevant literature published between the years 1966 and 2019 concerning various reconstructive techniques on proximal gastrectomy were selected. The postoperative outcomes and complications of the reconstructive techniques were assessed. Meta-analyses were performed using Rev-Man 5.0. A total of 29 studies investigating postoperative outcomes of double tract reconstruction, jejunal pouch interposition, jejunal interposition, esophagogastrostomy, and double flap reconstruction were finally selected in the quantitative analysis.
    RESULTS: Pooled incidences of reflux esophagitis for double tract reconstruction, jejunal pouch interposition, jejunal interposition esophagogastrostomy, and double flap reconstruction were 8.6%, 13.8%, 13.8%, 19.3%, and 8.9% respectively. Meta-analysis showed a decreased length of hospital in the JI group as compared to the JPI group (heterogeneity: Chi2 = 1.34, df = 1 (P = 0.25); I2 = 26%, test for overall effect: Z = 2.22 (P = 0.03). There was also a significant difference between JI and EG in length of hospital stay with heterogeneity: Chi2 = 1.40, df = 3 (P = 0.71); I2 = 0%, test for overall effect: Z = 5.04 (P < 0.00001). Operative time was less in the EG group as compared to the JI group (heterogeneity: Chi2 = 31.09, df = 5 (P < 0.00001); I2 = 84%, test for overall effect: Z = 32.35 (P < 0.00001).
    CONCLUSIONS: Although current reconstructive techniques present excellent anti-reflux efficacy, the optimal reconstructive method remains to be determined. The double flap reconstruction proved to lower the rate of complication, but the DTR, JI, JPI, and EG groups showed higher incidence of complications in anastomotic leakage, anastomotic stricture, and residual food. In the meta-analysis result, the complications between the JI, JPI, and EG were comparable but the EG group showed to have better postoperative outcomes concerning the operative time, blood loss, and length of hospital stay.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

公众号