Mediastinal drainage combined with upper mediastinal re-tunneling vs. mediastinal drainage alone in McKeown esophagectomy of esophageal cancer: a retrospective study.

IF 1.6 4区 医学 Q2 SURGERY
Frontiers in Surgery Pub Date : 2024-10-02 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1436176
Lei Dai, Xiang Tan, Mingwu Chen, Huajian Peng, Yongyong Wang
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引用次数: 0

Abstract

Background: Although mediastinal drainage may lower the risk of anastomotic leakage, the incident rate of anastomotic leakage is still high. The current study aimed to compare the effects of mediastinal drainage combined with upper mediastinal re-tunneling with mediastinal drainage only on anastomotic leakage after McKeown esophagectomy for esophageal cancer.

Methods: From October 2018 to March 2021, 52 patients diagnosed as esophageal carcinoma were included in the study. 21 patients received mediastinal drainage combined with upper mediastinal re-tunneling (re-tunneling group) and 31 received mediastinal drainage only (standard group) after McKeown esophagectomy. The incidence rate of anastomotic leakage, mediastinal infection, chylothorax, thoracic infection, the peak value of leukocyte count and the mortality related to anastomotic leakage were compared between the two groups.

Results: One (4.8%) patient in the re-tunneling group developed anastomotic leakage, and no patient experienced mediastinal infection or thoracic infection. Four (12.9%) patients in the standard group developed anastomotic leakage, and all these patients experienced mediastinal infection and thoracic infection (p < 0.05). The drainage volumes of patients in the re-tunneling group and the standard group were (170 ± 60) ml and (155 ± 45) ml, respectively, with no significant difference between the two groups (p > 0.05). The peak values of leukocyte count and temperature in the re-tunneling group were (14.28 ± 1.12) × 109/L and (38.6 ± 1.1) °C, both lower than that of the standard group[ (16.48 ± 1.15) × 109/L and (38.9 ± 1.2) °C, respectively]. But the difference was not statistically significant (p > 0.05). No anastomotic leakage related death occurred in both groups.

Conclusion: Mediastinal drainage combined with upper mediastinal re-tunneling after McKeown esophagectomy for esophageal cancer may decrease the risk of anastomotic leakage, mediastinal and thoracic infection, reduce the inflammatory response of patients, but did not increase the mortality related to anastomotic leakage.

Trial registration: The study was retrospectively registered.

食管癌麦氏食管切除术中纵隔引流术联合上纵隔再隧道术与单纯纵隔引流术的对比:一项回顾性研究。
背景:尽管纵隔引流可降低吻合口漏的风险,但吻合口漏的发生率仍然很高。本研究旨在比较纵隔引流联合上纵隔再通术与单纯纵隔引流对食管癌麦氏食管切除术后吻合口漏的影响:2018年10月至2021年3月,52例确诊为食管癌的患者纳入研究。21例患者在麦氏食管切除术后接受纵隔引流联合上纵隔再通(再通组),31例患者仅接受纵隔引流(标准组)。比较了两组吻合口漏、纵隔感染、乳糜胸、胸腔感染的发生率、白细胞计数峰值以及与吻合口漏相关的死亡率:结果:再通组有一名(4.8%)患者出现吻合口漏,没有患者出现纵隔感染或胸腔感染。标准组有四名患者(12.9%)出现吻合口漏,所有这些患者都出现了纵隔感染和胸腔感染(P P > 0.05)。再通组的白细胞计数和体温峰值分别为(14.28 ± 1.12)×109/L 和(38.6 ± 1.1)℃,均低于标准组[分别为(16.48 ± 1.15)×109/L 和(38.9 ± 1.2)℃]。但差异无统计学意义(P > 0.05)。两组患者均未发生与吻合口漏相关的死亡:结论:食管癌麦氏食管切除术后纵隔引流联合上纵隔再通术可降低吻合口漏、纵隔和胸腔感染的风险,减轻患者的炎症反应,但不会增加与吻合口漏相关的死亡率:该研究为回顾性注册。
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来源期刊
Frontiers in Surgery
Frontiers in Surgery Medicine-Surgery
CiteScore
1.90
自引率
11.10%
发文量
1872
审稿时长
12 weeks
期刊介绍: Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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