Application of esophageal varus extraction in the treatment of laryngopharyngeal and cervical esophageal tumors / 中华胸心血管外科杂志

ABSTRACT

Objective:To investigate the application and effect of esophageal varus extraction in the treatment of cervical tumors(laryngopharynx and cervical esophagus).Methods:A retrospective analysis was performed on 238 patients with cervical tumors(laryngopharynx and cervical esophagus) who underwent thoracic surgery in Beijing Tongren Hospital affiliated to Capital Medical University from March 2010 to March 2020. There were 135 males and 103 females, aged from 42 to 78 years, with a median age of 62 years.Surgical methods included open abdominal surgery in 96 cases and laparoscopic surgery in 142 cases. The intraoperative abdominal bleeding volume, abdominal operation time and postoperative abdominal drainage volume were analyzed. χ2 test was used to compare the clinical characteristics of the two groups, t test was used to compare the clinical indicators, and statistical software SPSS 13.0 was used to analyze. Results:No intraoperative death occurred in all patients.In the laparoscopic group, all cases successfully completed tubular gastric traction through the original esophageal bed to the neck, and completed cervical anastomosis.One patient(0.70%) was converted to thoracotomy due to aortic tear, and no post-operative bleeding occurred.No incision infection and wound liquefaction. Splenectomy was performed in 1 patient(1.04%), incision infection in 2 patients(2.08%), and fat liquefaction in 3 patients(3.12%) in the open surgery group.The intraoperative abdominal bleeding volume in the open surgery group and the laparoscopic group was(187±28)ml and(79±23)ml, respectively( t=1.836, P=0.032); the postoperative abdominal drainage volume in the two groups was(172±33)ml and(56±24)ml, respectively( t=1.964, P=0.028), and there was a significant difference between the two groups.The operation time of open operation group and laparoscopy group was(125±33) min and(118±27) min respectively( t=1.224, P=0.203), and there was no significant difference between the two groups. Conclusion:Laparoscopic esophageal varus extraction has advantages over traditional laparotomy in the treatment of laryngopharyngeal tumors and cervical esophageal tumors, such as beautiful incision, small surgical trauma, clear surgical field exposure and less postoperative complications, which conforms to the current minimally invasive treatment concept.The application of pneumoperitoneum-free suspension device solves the key links of mediastinal compression hemostasis after esophageal extubation and traction of tubular stomach to neck under pneumoperitoneum-free condition, so that laparoscopic surgery can be applied.However, such operations need to strictly grasp the indications to avoid the occurrence of serious complications.