論文

査読有り
2016年2月

Short-term outcomes after conventional transthoracic esophagectomy

NAGOYA JOURNAL OF MEDICAL SCIENCE
  • Yukiko Niwa
  • Masahiko Koike
  • Masashi Hattori
  • Naoki Iwata
  • Hideki Takami
  • Masamichi Hayashi
  • Mitsuro Kanda
  • Daisuke Kobayashi
  • Chie Tanaka
  • Suguru Yamada
  • Tsutomu Fujii
  • Goro Nakayama
  • Hiroyuki Sugimoto
  • Shuji Nomoto
  • Michitaka Fujiwara
  • Yasuhiro Kodera
  • 全て表示

78
1
開始ページ
69
終了ページ
78
記述言語
英語
掲載種別
研究論文(学術雑誌)
出版者・発行元
NAGOYA UNIV, SCH MED

In our department, we have attempted to reduce the incidence of complications of conventional esophagectomy. The objective of this retrospective study was to report the short-term outcomes of esophagectomy. We reviewed 138 consecutive patients who had undergone subtotal esophagectomy by combined laparotomy via a 12-cm upper abdominal vertical incision combined with right anterior muscle-sparing thoracotomy from August 2010 to August 2014. Most of the cervical para-esophageal lymph node dissection was completed within the thoracic cavity. We performed three-field dissection in patients with tumors in the upper or middle third of the esophagus with clinical lymph node metastases in the superior mediastinum; the others underwent two-field dissection. We performed neck anastomoses in patients undergoing three-field dissection and thoracic anastomoses in those undergoing two-field dissection. Effective postoperative pain management was achieved with a combination of epidural anesthesia and paravertebral block. Postoperative rehabilitation was instituted for early ambulation and recovery. Enteral nutrition via a duodenal feeding tube was administered from postoperative day 2. Median hospital stay after surgery was 15 days (range, 10-129). Rates for both 30-day and in-hospital mortality were 0%. Morbidity rate for all Clavien-Dindo grades was 41.3%, whereas the morbidity rate for Clavien-Dindo grades III and IV was 7.2%. Anastomotic leakage developed in two patients (1.4%), recurrent laryngeal nerve palsy in 11 (8.0%), and pneumonia in nine (6.5%). Good short-term outcomes, especially regarding anastomotic leaks, were achieved by consistent improvements in surgical techniques, optimization of several operative procedures, and appropriate perioperative management.

リンク情報
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000376944400007&DestApp=WOS_CPL
ID情報
  • ISSN : 2186-3326
  • eISSN : 0027-7622
  • Web of Science ID : WOS:000376944400007

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