Transhiatal esophagectomy: Clinical experience and refinements
Transhiatal esophagectomy: Clinical experience and refinements
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DOI：
10.1097/00000658-199909000-00012
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发表时间：
1999-09-01
影响因子：
9
通讯作者：
Iannettoni, MD
中科院分区：
文献类型：
--
作者：
Orringer, MB;Marshall, B;Iannettoni, MD
目的回顾作者在经腹食道切除术中的临床经验和改进方法。背景在过去20年中，食道切除术的应用日益增多，与经胸食道切除术相比，该方法的优点和安全性引起了争议。方法采用作者前瞻性建立的食道切除数据库和对这些患者的随访资料，对手术结果进行回顾性分析。结果1976~1998年，共手术1085例，其中良性病变占26%，癌症占74%。手术成功率98.6%，胃替代食道占96%。住院死亡率为4%。平均失血量为689毫升。主要并发症有吻合口漏(13%)、肺不张/肺炎(2%)、胸内出血、喉返神经麻痹、乳糜胸和气管撕裂(
ObjectiveTo review the authors' clinical experience with transhiatal esophagectomy (THE) and the refinements in this procedure that have evolved.BackgroundIncreased use of THE during the past two decades has generated controversy about the merits and safety of this approach compared with transthoracic esophageal resection. The authors' large THE experience provides a valuable basis for benchmarking data regarding the procedure.MethodsThe results of THE were analyzed retrospectively using the authors' prospectively established esophageal resection database and follow-up information on these patients.ResultsFrom 1976 to 1998, THE was performed in 1085 patients, 26% with benign disease and 74% with cancer. The procedure was possible in 98.6% of cases, Stomach was the esophageal substitute in 96%. The hospital mortality rate was 4%. Blood loss averaged 689 cc. Major complications were anastomotic leak (13%), atelectasis/pneumonia (2%), intrathoracic hemorrhage, recurrent laryngeal nerve paralysis, chylothorax, and tracheal laceration (