■一些研究报告了微创食管切除术优于传统的开放方法,特别是在术后发病率和死亡率方面。然而,关于老年人群的文献很少,并且仍然不清楚老年患者是否可以从普通人群的微创方法中受益。我们试图评估胸腔镜/腹腔镜(MIE)或全机器人(RAMIE)Ivor-Lewis食管切除术是否显着降低了老年人群的术后发病率。
我们分析了2016年至2021年在美因茨大学医院和帕多瓦大学医院接受开放式食管切除术或MIE/RAMIE的患者数据。老年患者定义为≥75岁。比较老年患者行开腹食管切除术或MIE/RAMIE的临床特点和术后转归。还进行了1对1匹配的比较。将<75岁的患者作为对照组。
■在老年患者中,MIE/RAMIE与较低的总发病率相关(39.7%与62.7%,p=0.005),肺部并发症少(32.8vs.56.9%,p=0.003)和较短的住院时间(13vs.18天,p=0.03)。匹配后获得了可比的发现。同样,在<75岁的患者中,发病率降低(31.2%vs.43.5%,p=0.01)和更少的肺部并发症(22%vs.36%,在微创组中检测到p=0.001)。
■微创食管切除术改善了老年患者的术后病程,降低了术后并发症的总体发生率,尤其是肺部并发症。
UNASSIGNED: Several studies reported the advantages of minimally invasive esophagectomy over the conventional open approach, particularly in terms of postoperative morbidity and mortality. The literature regarding the elderly population is however scarce and it is still not clear whether elderly patients may benefit from a minimally invasive approach as the general population. We sought to evaluate whether thoracoscopic/ laparoscopic (
MIE) or fully robotic (RAMIE) Ivor-Lewis esophagectomy significantly reduces postoperative morbidity in the elderly population.
UNASSIGNED: We analyzed data of patients who underwent open esophagectomy or
MIE/RAMIE at Mainz University Hospital and at Padova University Hospital between 2016 and 2021. Elderly patients were defined as those ≥ 75 years old. Clinical characteristics and the postoperative outcomes were compared between elderly patients who underwent open esophagectomy or
MIE/RAMIE. A 1-to-1 matched comparison was also performed. Patients < 75 years old were evaluated as a control group.
UNASSIGNED: Among elderly patients
MIE/RAMIE were associated with a lower overall morbidity (39.7% vs. 62.7%, p=0.005), less pulmonary complications (32.8 vs. 56.9%, p=0.003) and a shorter hospital stay (13 vs. 18 days, p=0.03). Comparable findings were obtained after matching. Similarly, among < 75 years-old patients, a reduced morbidity (31.2% vs. 43.5%, p=0.01) and less pulmonary complications (22% vs. 36%, p=0.001) were detected in the minimally invasive group.
UNASSIGNED: Minimally invasive esophagectomy improves the postoperative course of elderly patients reducing the overall incidence of postoperative complications, particularly of pulmonary complications.