背景:这项回顾性研究的目的是比较单个肋间完全微创IvorLewis食管切除术(MIIE)与多个肋间MIIE的安全性和可行性。
方法:在2016年1月至2022年12月之间,收集了528例成功接受完全微创食管切除术的患者的临床数据。在这些患者中,294接受MIIE,其中200人接受单肋间入路,94人接受多肋间入路。将倾向评分匹配(PSM)应用于294名患者的队列。随后,回顾性分析围手术期结局和其他相关临床资料.
结果:共有294名患者接受了PSM,89组患者数据(共178人)平衡良好,纳入随访统计.与多个肋间组相比,单个肋间组手术时间较短(280分钟vs.310分钟;p<0.05)。此外,围手术期主要并发症发生率差异无统计学意义(p>0.05)。采样的淋巴结总数(25.30vs.27.55,p>0.05)和两侧喉返神经淋巴结采样(p>0.05)没有显着差异。单个肋间组术后长期吗啡使用率较低(0,0-60vs.20,20-130;p<0.01),总临时添加(10,0-30vs.20,20-40;p<0.01)和术后前3天的临时使用(0,0-15vs.10,10-20;p<0.01)比多肋组。在年龄上没有显著差异,性别,肿瘤位置或淋巴结清扫程度或在临床因素中介于单肋间组之间(p>0.05)。
结论:两种技术均可用于食管癌的治疗。与多个肋间MIIE相比,其可行性已在国际上得到证明,单肋间技术也可以应用于不同年龄段和性别以及不同肿瘤部位的患者。它可以为外科医生提供额外的手术选择。
背景:本研究由浙江大学医学院附属第二医院伦理委员会回顾性注册,书面知情同意书免于伦理审查.注册号为20,230,326。注册日期为2023.03.26。
BACKGROUND: The purpose of this retrospective study was to compare the safety and feasibility of single-intercostal totally minimally invasive Ivor Lewis esophagectomy (MIIE) with those of multiple-intercostal MIIE.
METHODS: Between January 2016 and December 2022, clinical data were collected for 528 patients who successfully underwent totally minimally invasive esophagectomy. Among these patients, 294 underwent MIIE, with 200 undergoing the single-intercostal approach and 94 undergoing the multiple-intercostal approach. Propensity score matching (PSM) was applied to the cohort of 294 patients. Subsequently, perioperative outcomes and other pertinent clinical data were analyzed retrospectively.
RESULTS: A total of 294 patients were subjected to PSM, and 89 groups of patient data (178 persons in total) were well balanced and included in the follow-up statistics. Compared to the multiple intercostal group, the single intercostal group had a shorter operative time (280 min vs. 310 min; p < 0.05). Moreover, there was no significant difference in the incidence of major perioperative complications (p > 0.05). The total number of lymph nodes sampled (25.30 vs. 27.55, p > 0.05) and recurrent laryngeal nerve lymph nodes sampled on the both sides (p > 0.05) did not significantly differ. The single intercostal group had lower postoperative long-term usage of morphine (0,0-60 vs. 20,20-130; p < 0.01), total temporary addition (10,0-30 vs. 20,20-40; p < 0.01) and temporary usage in the first 3 days after surgery (0,0-15 vs. 10,10-20; p < 0.01) than did the multicostal group.There were no significant differences in age, sex, tumor location or extent of lymphadenectomy or in the clinical factors between the single-intercostal group (p > 0.05).
CONCLUSIONS: Both techniques can be used for the treatment of esophageal cancer. Compared to multiple intercostal MIIE, the feasibility of which has been proven internationally, the single intercostal technique can also be applied to patients of different age groups and sexes and with different tumor locations. It can provide surgeons with an additional surgical option.
BACKGROUND: This study was retrospectively registered by the Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine, and written informed consent was exempted from ethical review. The registration number was 20,230,326. The date of registration was 2023.03.26.