270.经食管裂孔食管胃交界处癌症手术中心脏直径与吻合麻烦之间的关系分析

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Yudai Higuchi, Suguru Maruyama, Katsutoshi Shoda, Hidenori Akaike, Yoshihiko Kawaguchi, Ryo Saito, Koichi Takiguchi, Wataru Izumo, Yuki Nakata, Kensuke Shiraishi, Shinji Furuya, Hidetake Amemiya, Hiromichi Kawaida, Daisuke Ichikawa
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引用次数: 0

摘要

背景 近年来,食管胃交界处(EGJ)癌症的数量不断增加,经食管裂孔下段食管切除术被广泛用于食管侵犯较短的病例。然而,由于心脏受压,经食管裂孔的纵隔手术视野有时较差,这些病例的切除和重建往往比较困难。因此,我们对心脏直径对术后短期疗效的影响进行了回顾性研究。方法 2004年6月至2022年12月,我院共有97名患者接受了胃食管癌根治术,其中67名患者接受了经食道入路手术。我们回顾性分析了术前胸片心胸比(CTR)和超声心动图左心室舒张期直径(LVDd)与经食管裂孔入路患者术后并发症的关系。结果 术前CTR为>50%的患者吻合口漏率明显更高(33%对7%,p<0.05),同样,以43毫米为分界线将LVDd分为两组时,心脏直径较大的患者吻合口漏率明显更高(69%对24%,p<0.05)。我们使用 CTR、ASA-PS、失血量、手术时间、体重指数和肿瘤直径进行了多变量分析,并将 CTR 定义为吻合口漏的独立风险因素(OR:7.76,95%CI:1.45-41.4,p<0.05)。结论 经食道入路可用于 EGJ 癌切除术。然而,对于有心脏合并症或术前CTR或LVDd较大的患者,应特别注意预防吻合口漏。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
270. ANALYSIS OF THE RELATIONSHIP BETWEEN CARDIAC DIAMETER AND ANASTOMOTIC TROUBLE IN TRANS HIATAL ESOPHAGOGASTRIC JUNCTION CANCER SURGERY
Background The number of esophagogastric junction (EGJ) cancers has been increasing in recent years, and the trans hiatal lower esophagectomy is widely used for cases with shorter esophageal invasion. However, the mediastinal surgical view through the hiatus is sometimes poor due to cardiac compression, and resection and reconstruction are often difficult in these cases. We therefore retrospectively examined the influence of cardiac diameter on short-term postoperative outcomes. Methods From June 2004 to December 2022, 97 patients underwent radical surgery for EGJ cancer at our hospital, of those 67 patients underwent trans-hiatal approach. We retrospectively analyzed the relationship between cardiothoracic ratio (CTR) on preoperative chest radiographs and left ventricular diastolic diameter (LVDd) on echocardiography and postoperative complications in patients underwent trans hiatal approach. Results Patients with preoperative CTR >50% had a significantly higher rate of anastomotic leakage (33% v.s. 7%, p<0.05), and similarly for LVDd, when divided into two groups using 43 mm as cut-off, patients with larger heart diameter had significantly more anastomotic leakage (69% v.s. 24%, p<0.05). We performed a multivariate analysis using CTR, ASA-PS, blood loss, operative time, BMI, and tumor diameter, and defined CTR as an independent risk factor for anastomotic leakage (OR: 7.76, 95%CI: 1.45-41.4, p<0.05). Conclusion Trans-hiatal approach can be used for resection of EGJ cancer. However, special attention should be paid to the prevention of anastomotic leakage in patients with cardiac comorbidities or a large preoperative CTR or LVDd.
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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