机器人辅助McKeown 食管癌切除术近期疗效分析

摘要/Abstract

目的：探讨机器人McKeown 食管癌切除术的临床应用，评估其安全性和短期疗效。方法：回顾性分析2017 年6 月~2019 年12 月单一手术组行机器人McKeown 食管癌切除术121 例患者的临床资料和短期临床结果。结果：121 例患者中位年龄60（34~77）岁，其中男100 例，女21 例，32 例行新辅助治疗。平均手术时间（320.2±43.1）min，失血量（197.4±33.4）ml，每例淋巴结清扫23（5~71）个。术后病理证实鳞癌患者109 例；32 例行新辅助治疗的患者中，9 例获得病理完全缓解（28.1%）。74 例左喉返神经旁淋巴结清扫数目为4（1~13）个，转移率为21.6%（16/74）；101 例右喉返神经旁淋巴结清扫数目为3（1~13）个，转移率为18.8%（19/101）。术后总体并发症发生率为34.7%（42/121），包括声嘶17 例（14.0%）、肺炎13 例（10.7%）、吻合口瘘9 例（7.4%）、胸腔积液4 例（3.3%）、切口感染2 例（1.7%）、乳糜胸1 例（0.8%）、其他并发症共8 例；术后9 例患者入住ICU 时间5（1~21）d。全组患者无死亡病例，术后中位住院时间14（13~64）d。结论：机器人McKeown 食管癌切除术应用于食管癌安全可行，可获得较满意的短期疗效。

To investigate the clinical application of robot-assisted McKeown esophagectomy (RAME) and evaluate its safety and short-term outcomes. Methods: The clinical data and short-term outcomes of 121 patients underwent RAME from June 2017 to December 2019 in a single-operation group were retrospectively analyzed. Results: The median age of 121 patients was 60 (34~77) years old, including 100 males and 21 females, of which 32 patients received neoadjuvant therapy. The average operation time was (320.2±43.1)min, the blood loss was (197.4±33.4)ml and the median number of dissected lymph node was 23 (5~71). 109 patients were confirmed with squamous cell carcinoma by postoperative pathology, and 9 patients achieved pathological complete remission among 32 patients whom underwent neoadjuvant therapy (9/32, 28.1%). 74 cases underwent lymph node dissection at left laryngeal recurrent nerve (LRN) and the median number of dissected lymph node was 4 (1~13) with metastasis rate of 21.6% (16/74) . 101 cases underwent lymph node dissection at right LRN and the median number of dissected lymph node was 3 (1~13) with metastasis rate of 18.8% (19/101). The overall incidence of postoperative complication was 34.7% (42/121), including 17 cases of hoarseness, 13 cases of pneumonia, 9 cases of anastomotic leakages, 4 cases of pleural effusion, 2 cases of incision infection, 1 case of chylothorax, and 8 cases of other complications. Nine patients were admitted to the ICU after surgery, and the median ICU stay was 5 (1~21) d. No perioperative death was found, and the median postoperative hospital stay was 14 (13~64) d.

稿件信息

参考文献

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