中国实用外科杂志2024，Vol.44Issue(10)：1155-1158,4.DOI:10.19538/j.cjps.issn1005-2208.2024.10.15
术前内镜下钛夹定位联合术中内镜和冰冻病理检查用于食管胃结合部腺癌腹腔镜手术切缘判定价值研究
Application of preoperative endoscopic titanium clip positioning combined with intraoperative endoscopy and quick-frozen pathology to the margin determination in laparoscopic surgery for adenocarcinoma of the esophagogastric junction
摘要
Abstract
Objective To preliminarily explore the application value of preoperative titanium clip positioning combined with intraoperative endoscopy and intraoperative quick-frozen pathology for the margin analysis in laparoscopic surgery for adenocarcinoma of the esophagogastric junction(AEG).Methods A retrospective analysis was conducted on the clinical data of 133 patients who underwent laparoscopic surgery for AEG between January 2021 and December 2022 at Changzhi People's Hospital.All patients received preoperative titanium clip positioning,intraoperative endoscopy,and intraoperative quick-frozen pathology margin analysis.Observational indicators included:Intraoperative endoscopic positioning time,the first positive resection margin rate,postoperative complications,postoperative hospital stay,rate of unplanned reoperations during the perioperative period,and mortality rate.Results The mean intraoperative endoscopic positioning time was(4.2±1.3)min,with an average time of 7.4 minutes for the first 6 cases.The first positive resection margin rate was 3.0％,but all were negative upon the second examination.No anastomotic leakage or other complications occurred intraoperatively.Postoperatively,4 patients(3.0％)experienced hoarseness and sore throat,with 1 case of partial subluxation of the left cricoarytenoid joint,which resolved after treatment.12 patients developed complications classified as Clavien-Dindo grade ≥ Ⅲ,with an overall complication rate of 9.0％.All patients recovered with conservative treatment,without the need for secondary surgery,and no perioperative mortality was observed.The mean hospital stay was(12.0±4.7)d.Conclusion Preoperative endoscopic titanium clip positioning combined with intraoperative endoscopy and quick-frozen pathology margin analysis can potentially enable precise tumor resection and achieve negative surgical margins in laparoscopic A EG surgery.关键词
食管胃结合部腺癌/腹腔镜/切缘定位/术中内镜/钛夹定位Key words
adenocarcinoma of esophagogastric junction/laparoscopy/resection margin positioning/intraoperative gastroscopy/titanium clip positioning分类
医药卫生引用本文复制引用
杨瑞,齐韶铭,胡文庆,刘晖,宋东阳,崔鹏,魏伟,宗亮,乔鋆,王楠,王博,徐泽坤..术前内镜下钛夹定位联合术中内镜和冰冻病理检查用于食管胃结合部腺癌腹腔镜手术切缘判定价值研究[J].中国实用外科杂志,2024,44(10):1155-1158,4.基金项目
山西省卫健委四个一批-重大科技攻关专项项目(No.2022XM02) （No.2022XM02）
吴阶平医学基金会项目(No.320.6750.2020-11-6) （No.320.6750.2020-11-6）
