单纯腹腔镜下入路可降低食管癌患者行食管切除术后肺炎的发生率。

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Esophagus Pub Date : 2025-04-01 Epub Date: 2025-02-10 DOI:10.1007/s10388-025-01110-1

Yoshiro Yukawa, Kotaro Yamashita, Kota Momose, Takuro Saito, Koji Tanaka, Tomoki Makino, Kazuyoshi Yamamoto, Tsuyoshi Takahashi, Yukinori Kurokawa, Ryohei Kawabata, Atsushi Takeno, Kiyokazu Nakajima, Hidetoshi Eguchi, Yuichiro Doki

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引用次数: 0

摘要

背景：微创食管切除术治疗食管癌已越来越普遍，以减少术后肺炎。然而，没有上腹部切口的纯腹腔镜腹部操作的有效性尚不清楚。方法：我们评估了纯腹腔镜手术（LAP）与手辅助腹腔镜手术（HALS）在食管切除术中的应用。在2019年至2023年期间，共有344名连续接受食管癌根治性食管切除术的患者入组；HALS治疗235例，LAP治疗109例。使用倾向评分匹配分析比较两组患者的围手术期和术后结果。结果：采用倾向评分匹配法对HALS组和LAP组各92例患者进行比较。两组患者的临床病理特征无明显差异。HALS组术后肺炎的发生率明显高于LAP组(分别为30% vs 11%；p = 0.001)。多因素logistic分析显示，HALS与术后肺炎（优势比3.82,P = 0.002）、年龄和男性独立相关。结论：LAP可降低食管癌切除术患者术后肺炎的发生率。

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A purely laparoscopic approach can reduce the incidence of postoperative pneumonia in esophageal cancer patients undergoing esophagectomy.

Background: Minimally invasive esophagectomy for esophageal cancer has become increasingly common to reduce postoperative pneumonia. However, the usefulness of pure laparoscopic abdominal manipulation without an upper abdominal incision remains unclear.

Methods: We evaluated the utility of pure laparoscopic surgery (LAP) vs. hand-assisted laparoscopic surgery (HALS) in esophagectomy. A total of 344 consecutive patients who underwent curative esophagectomy for esophageal cancer from 2019 to 2023 were enrolled; 235 patients were treated with HALS and 109 with LAP. The peri- and postoperative outcomes were compared between the two groups using a propensity score-matched analysis.

Results: Propensity score matching was used to compare 92 patients each in the HALS and LAP groups. Clinicopathological characteristics did not differ between the two groups. The incidence of postoperative pneumonia was significantly higher in the HALS group than in the LAP group (30% vs. 11%, respectively; P = 0.001). Multivariate logistic analysis showed that HALS was independently associated with postoperative pneumonia (odds ratio 3.82, P = 0.002), along with older age and male sex.

Conclusions: LAP may reduce the incidence of postoperative pneumonia in esophageal cancer patients who undergo esophagectomy.

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来源期刊

Esophagus GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.90

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.