Total laparoscopic gastric tube formation for McKeown in patients with esophageal squamous cell carcinoma

doi:10.3877/cma.j.issn.2095-8773.2024.04.02

Abstract

Abstract:

Objective

To assess the feasibility and safety of utilizing total laparoscopic gastric tube formation for McKeown in patients with esophageal squamous cell carcinoma.

Methods

Forty patients with esophageal squamous cell carcinoma who underwent McKeown esophagectomy at Shanghai Chest Hospital from December 2023 to April 2024 were enrolled.The patients were divided evenly into two groups according to abdominal procedure，one group undergoing total laparoscopic gastric tube formation and the other group undergoing gastric tube formation with a longitudinal midline abdominal incision of approximately 5-8 cm in length.Perioperative indicators of both groups were retrospectively analysed.

Results

All 40 operations were successful without any conversions to open chest or abdominal incisions.There were no instances of mortality，chylothorax，or reoperation complications in either group.No significant differences were observed between the two groups in terms of operation time （240.00±38.15 vs 229.50±37.90 min，P=0.39），blood loss（188.75±75.4 vs 172.50±52.9 mL，P=0.43），lymph node dissection （23.2±6.12 vs 21.7±5.26，P=0.40），or length of the gastric tube in the neck region （11.70±2.47 vs 11.8±2.07 cm，P=0.89）.Additionally，there was no significant difference in postoperative complications such as anastomotic fistula，pneumonia，and pleural effusion between the two groups （P ＞0.05）.Postoperative hospital stay also did not significantly differ between the two groups （8.30±2.36 vs 8.10±3.09 days，P=0.82）.However，pain scores on the first postoperative day were significantly lower in the total laparoscopic gastric tube formation group （4.35±1.39 vs 8.10±3.09，P = 0.02）.

Conclusions

The use of total laparoscopic gastric tube formation to format gastric tube in McKeown esophagectomy for esophageal squamous cell carcinoma was safe and feasible.

Key words: Total laparoscopic, Gastric tube, Esophageal carcinoma

Chunguang Li, Yang Yang, Bin Li, Rong Hua, Zhigang Li. Total laparoscopic gastric tube formation for McKeown in patients with esophageal squamous cell carcinoma[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2024, 11(04): 219-224.

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Figures/Tables 5

References 15

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参数	腹腔镜管状胃组	小切口管状胃组	χ ²	P
年龄（岁）	64.5±5.07	62.2±8.2	—	0.31
性别			0.00	＞0.99
男	16（80%）	15（75%）
女	4（20%）	5（25%）
高血压	3（15%）	4（20%）	0.00	＞0.99
糖尿病	2（10%）	1（5%）	0.00	＞0.99
术前新辅助	14（70%）	10（50%）	1.67	0.20
肿瘤分期			0.90	0.34
Ⅰ～Ⅱ期	9（45%）	12（60%）
Ⅲ期	11（55%）	8（40%）

参数	腹腔镜管状胃组	小切口管状胃组	χ ²	P
年龄（岁）	64.5±5.07	62.2±8.2	—	0.31
性别			0.00	＞0.99
男	16（80%）	15（75%）
女	4（20%）	5（25%）
高血压	3（15%）	4（20%）	0.00	＞0.99
糖尿病	2（10%）	1（5%）	0.00	＞0.99
术前新辅助	14（70%）	10（50%）	1.67	0.20
肿瘤分期			0.90	0.34
Ⅰ～Ⅱ期	9（45%）	12（60%）
Ⅲ期	11（55%）	8（40%）

参数	腹腔镜管状胃组	小切口管状胃组	χ ²	P
手术时间（min）	240.00±38.15	229.50±37.90	—	0.39
出血量（mL）	188.75±75.4	172.50±52.9	—	0.43
淋巴结清扫个数	23.2±6.12	21.7±5.26	—	0.40
颈部管状胃长度*（cm）	11.70±2.47	11.8±2.07	—	0.89
疼痛评分**	4.35±1.39	5.35±1.22	—	0.02
吻合口瘘	1（5%）	1（5%）	0.00	＞0.99
声音嘶哑	3（15%）	2（10%）	0.00	＞0.99
肺炎	2（10%）	1（5%）	0.00	＞0.99
术后住院时间（天）	8.30±2.36	8.10±3.09	—	0.82

参数	腹腔镜管状胃组	小切口管状胃组	χ ²	P
手术时间（min）	240.00±38.15	229.50±37.90	—	0.39
出血量（mL）	188.75±75.4	172.50±52.9	—	0.43
淋巴结清扫个数	23.2±6.12	21.7±5.26	—	0.40
颈部管状胃长度*（cm）	11.70±2.47	11.8±2.07	—	0.89
疼痛评分**	4.35±1.39	5.35±1.22	—	0.02
吻合口瘘	1（5%）	1（5%）	0.00	＞0.99
声音嘶哑	3（15%）	2（10%）	0.00	＞0.99
肺炎	2（10%）	1（5%）	0.00	＞0.99
术后住院时间（天）	8.30±2.36	8.10±3.09	—	0.82

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