首页|Comparison between different reconstruction routes in esophageal squamous cell carcinoma

Comparison between different reconstruction routes in esophageal squamous cell carcinoma

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To compare postoperative complications and prognosis of esophageal squamous cell carcinoma patients treated with different routes of reconstruction.METHODS:After obtaining approval from the Medical Ethics Committee of the Sun Yat-Sen University Cancer Center,we retrospectively reviewed data from 306 consecutive patients with histologically diagnosed esophageal squamous cell carcinoma who were treated between 2001 and 2011.All patients underwent radical McKeown-type esophagectomy with at least two-field lymphadenectomy.Regular follow-up was performed in our outpatient department.Postoperative complications and long-term survival were analyzed by treatment modality,baseline patient characteristics,and operative procedure.Data from patients treated via the retrosternal and posterior mediastinal routes were compared.RESULTS:The posterior mediastinal and retrosternal reconstruction routes were employed in 120 and 186patients,respectively.Pulmonary complications were the most common complications experienced during the postoperative period (46.1% of all patients;141/306).Compared to the retrosternal route,the posterior mediastinal reconstruction route was associated with a lower incidence of anastomotic stricture (15.8%vs 27.4%,P =0.018) and less surgical bleeding (242.8± 114.2 mL vs 308.2 ± 168.4 mL,P < 0.001).The median survival time was 26.8 mo (range:1.6-116.1mo).Upon uni/multivariate analysis,a lower preoperative albumin level (P =0.009) and a more advanced pathological stage (pT; P =0.006; pN; P < 0.001)were identified as independent factors predicting poor prognosis.The reconstruction route did not influence prognosis (P =0.477).CONCLUSION:The posterior mediastinal route of reconstruction reduces incidence of postoperative complications but does not affect survival.This route is recommended for resectable esophageal squamous cell carcinoma.

Esophageal carcinomaRoute of reconstructionPosterior mediastinalRetrosternalComparison

Yu-Zhen Zheng、Shu-Qin Dai、Wei Li、Xun Cao、Xin Wang、Jian-Hua Fu、Peng Lin

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Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center,Guangzhou 510060, Guangdong Province, China

Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou 510060, Guangdong Province, China

Department of Anesthesia, Sun Yat-Sen University Cancer Center, Guangzhou 510060, Guangdong Province, China

广东省科技项目广东省科技项目

2010B0316002202008B030303008

2012

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子:1.001
ISSN:1007-9327
年,卷(期):2012.18(39)
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