Short Term Complications and Safety Analysis of Retrosternal Reconstruction Pathway Combined with Postoperative Adjuvant Radiotherapy in Minimally Invasive Mckeown Esophagectomy
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2022.0417
- VernacularTitle:胸骨后重建路径联合术后辅助放疗在微创Mckeown食管癌切除术近期并发症与安全性分析
- Author:
Jie-yong TIAN
1
;
Xin-yu MEI
1
;
Tian-ci ZHANG
1
;
Guang-wen XU
1
;
Ran XIONG
1
Author Information
1. Department of Thoracic Surgery，The First Affiliated Hospital，University of Science and Technology of China//Anhui Provincial Hospital，Hefei 230001，China
- Publication Type:Journal Article
- Keywords:
esophageal carcinoma;
Mckeown operation;
adjuvant radiotherapy;
retrosternal route
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2022;43(4):653-660
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo compare and analyze the effect of tubular gastric transsternal route and posterior mediastinal route combined with postoperative adjuvant radiotherapy on the short-term complications and safety of minimally invasive Mckeown esophageal carcinoma resection. MethodsRetrospective analysis of 89 patients who underwent minimally invasive Mckeown esophagectomy in the Department of thoracic surgery of the First Affiliated Hospital of China University of science and technology from January 2020 to June 2021. Some patients received postoperative adjuvant radiotherapy. According to the tubular gastric lifting pathway， they were divided into two groups： retrosternal route group and posterior mediastinal route group， including 39 cases in the retrosternal route group and 50 cases in the posterior mediastinal route group. The clinical characteristics and perioperative complications of the two groups were compared. ResultsThere was no significant difference in clinical characteristics between the two groups （P>0.05）； there was no significant difference in operation time， intraoperative bleeding， postoperative drainage and postoperative hospital stay between the two groups （P>0.05）. In addition， the incidence of pulmonary infection in the posterior mediastinal pathway group was higher than that in the retrosternal pathway group， and the difference was not statistically significant （P>0.05）. The incidence of gastroesophageal reflux in the posterior mediastinal route group was higher than that in the retrosternal route group， and the difference was statistically significant （P<0.05）. A total of 30 patients received adjuvant radiotherapy （10 cases in the retrosternal route group and 20 cases in the posterior mediastinal route group）. The incidence of radioactive gastritis in the retrosternal route group was lower than that in the posterior mediastinal route group （1 case had acute radioactive esophagitis， grade 1； In the posterior mediastinal route group， 6 patients developed acute radiation esophagitis （gastritis）， there were 2 cases in grade 1 and 4 cases in grade 2）. ConclusionThe short-term efficacy and safety of tubular gastric retrosternal route and posterior mediastinal route in minimally invasive Mckeown esophagectomy are consistent， but the incidence of gastroesophageal reflux after retrosternal route is lower.
