JAMA Surg:胸内vs颈部吻合对食管癌经胸微创食管切除术后吻合口渗漏率的影响

2021-05-17 MedSci原创 MedSci原创

对于接受经胸微创食管切除术的食管癌患者,胸内吻合在降低术后吻合口渗漏率,改善患者预后方面更具优势

近年来,西方国家食管癌的发病率不断上升,已成为第六大常见肿瘤及肿瘤死亡因素。经胸微创食管切除术(MIE)是最常用的食管癌外科治疗手段,并辅以新辅助放化疗或围手术期化疗。经胸食管切除术可分为颈部与胸内吻合两种术式,而吻合口渗漏是MIE后一种严重的并发症,其发病率较高,导致患者术后生活质量下降,长期生存率降低。近日研究人员比较了MIE颈部与胸内吻合对术后吻合口渗漏率的影响。

本次研究在荷兰9个医院开展,择期进行治疗性切除的食管癌或胃食管交界癌患者参与,随机接受MIE颈部或胸内吻合。研究的主要终点为需要内镜、放射学或手术干预的吻合口渗漏,次要终点是总吻合口漏率、其他术后并发症、ICU住院时间、死亡率和生活质量。

245名患者参与研究。122名接受MIE胸内吻合的患者中,15人出现需要二次干预的吻合口渗漏(12.3%),而123名接受MIE颈内吻合的患者中,39人出现需要二次干预的吻合口渗漏(31.7%)。MIE胸内吻合组总的吻合口渗漏率为12.3%,MIE颈内吻合组高达34.1%。组间ICU治疗时间、死亡率以及总体生活质量差异不显著,但胸内吻合在严重并发症(风险差异-11.3%)、喉返神经麻痹率(-7.3%)以及生活质量评分3个子集评分(平均差异:吞咽困难-12.2;吞咽窒息-10.3;语言问题-15.3)方面有优势。

组间主次要终点差异

研究认为,对于接受经胸微创食管切除术的食管癌患者,胸内吻合在降低术后吻合口渗漏率,改善患者预后方面更具优势。

原始出处:

Frans van Workum et al. Intrathoracic vs Cervical Anastomosis After Totally or Hybrid Minimally Invasive Esophagectomy for Esophageal Cancer A Randomized Clinical Trial.JAMA Surg. May 12, 2021.

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    2021-11-08 wakingday

    这个颈部吻合口瘘达到30%以上,是认真的吗?

    0

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  4. [GetPortalCommentsPageByObjectIdResponse(id=1877424, encodeId=994418e74247d, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Thu Apr 28 18:14:22 CST 2022, time=2022-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1068164, encodeId=82ff1068164b6, content=这个颈部吻合口瘘达到30%以上,是认真的吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44ce72633, createdName=wakingday, createdTime=Mon Nov 08 16:57:05 CST 2021, time=2021-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993055, encodeId=a7e5199305538, content=<a href='/topic/show?id=67ab101064b7' target=_blank style='color:#2F92EE;'>#食管切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101064, encryptionId=67ab101064b7, topicName=食管切除术)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKjqGDO7icVKUiaT7urgwXvnvzWtp0fMFU46Xfib8oavFKygiaWtibXReS6ZUh3PImsNicGAwTO5HXxoicnA/132, createdBy=ee262500130, createdName=ms7474195563676018, createdTime=Tue Jul 13 11:14:22 CST 2021, time=2021-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317100, encodeId=1454131e10099, content=<a href='/topic/show?id=df8950505a2' target=_blank style='color:#2F92EE;'>#微创#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50505, encryptionId=df8950505a2, topicName=微创)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437632, encodeId=1a29143e632ad, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589856, encodeId=63341589856ec, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036622, encodeId=44fd103662261, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue May 18 00:14:22 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966432, encodeId=25d09664323c, content=已读,真是受益匪浅呀!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Mon May 17 23:31:30 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966403, encodeId=64ef9664032f, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon May 17 22:01:14 CST 2021, time=2021-05-17, status=1, ipAttribution=)]
    2021-05-19 vera_1203
  5. [GetPortalCommentsPageByObjectIdResponse(id=1877424, encodeId=994418e74247d, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Thu Apr 28 18:14:22 CST 2022, time=2022-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1068164, encodeId=82ff1068164b6, content=这个颈部吻合口瘘达到30%以上,是认真的吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44ce72633, createdName=wakingday, createdTime=Mon Nov 08 16:57:05 CST 2021, time=2021-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993055, encodeId=a7e5199305538, content=<a href='/topic/show?id=67ab101064b7' target=_blank style='color:#2F92EE;'>#食管切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101064, encryptionId=67ab101064b7, topicName=食管切除术)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKjqGDO7icVKUiaT7urgwXvnvzWtp0fMFU46Xfib8oavFKygiaWtibXReS6ZUh3PImsNicGAwTO5HXxoicnA/132, createdBy=ee262500130, createdName=ms7474195563676018, createdTime=Tue Jul 13 11:14:22 CST 2021, time=2021-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317100, encodeId=1454131e10099, content=<a href='/topic/show?id=df8950505a2' target=_blank style='color:#2F92EE;'>#微创#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50505, encryptionId=df8950505a2, topicName=微创)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437632, encodeId=1a29143e632ad, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589856, encodeId=63341589856ec, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036622, encodeId=44fd103662261, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue May 18 00:14:22 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966432, encodeId=25d09664323c, content=已读,真是受益匪浅呀!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Mon May 17 23:31:30 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966403, encodeId=64ef9664032f, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon May 17 22:01:14 CST 2021, time=2021-05-17, status=1, ipAttribution=)]
    2021-05-19 zhouqu_8
  6. [GetPortalCommentsPageByObjectIdResponse(id=1877424, encodeId=994418e74247d, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Thu Apr 28 18:14:22 CST 2022, time=2022-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1068164, encodeId=82ff1068164b6, content=这个颈部吻合口瘘达到30%以上,是认真的吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44ce72633, createdName=wakingday, createdTime=Mon Nov 08 16:57:05 CST 2021, time=2021-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993055, encodeId=a7e5199305538, content=<a href='/topic/show?id=67ab101064b7' target=_blank style='color:#2F92EE;'>#食管切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101064, encryptionId=67ab101064b7, topicName=食管切除术)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKjqGDO7icVKUiaT7urgwXvnvzWtp0fMFU46Xfib8oavFKygiaWtibXReS6ZUh3PImsNicGAwTO5HXxoicnA/132, createdBy=ee262500130, createdName=ms7474195563676018, createdTime=Tue Jul 13 11:14:22 CST 2021, time=2021-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317100, encodeId=1454131e10099, content=<a href='/topic/show?id=df8950505a2' target=_blank style='color:#2F92EE;'>#微创#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50505, encryptionId=df8950505a2, topicName=微创)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437632, encodeId=1a29143e632ad, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589856, encodeId=63341589856ec, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036622, encodeId=44fd103662261, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue May 18 00:14:22 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966432, encodeId=25d09664323c, content=已读,真是受益匪浅呀!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Mon May 17 23:31:30 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966403, encodeId=64ef9664032f, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon May 17 22:01:14 CST 2021, time=2021-05-17, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1877424, encodeId=994418e74247d, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Thu Apr 28 18:14:22 CST 2022, time=2022-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1068164, encodeId=82ff1068164b6, content=这个颈部吻合口瘘达到30%以上,是认真的吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44ce72633, createdName=wakingday, createdTime=Mon Nov 08 16:57:05 CST 2021, time=2021-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993055, encodeId=a7e5199305538, content=<a href='/topic/show?id=67ab101064b7' target=_blank style='color:#2F92EE;'>#食管切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101064, encryptionId=67ab101064b7, topicName=食管切除术)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKjqGDO7icVKUiaT7urgwXvnvzWtp0fMFU46Xfib8oavFKygiaWtibXReS6ZUh3PImsNicGAwTO5HXxoicnA/132, createdBy=ee262500130, createdName=ms7474195563676018, createdTime=Tue Jul 13 11:14:22 CST 2021, time=2021-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317100, encodeId=1454131e10099, content=<a href='/topic/show?id=df8950505a2' target=_blank style='color:#2F92EE;'>#微创#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50505, encryptionId=df8950505a2, topicName=微创)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437632, encodeId=1a29143e632ad, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589856, encodeId=63341589856ec, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036622, encodeId=44fd103662261, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue May 18 00:14:22 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966432, encodeId=25d09664323c, content=已读,真是受益匪浅呀!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Mon May 17 23:31:30 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966403, encodeId=64ef9664032f, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon May 17 22:01:14 CST 2021, time=2021-05-17, status=1, ipAttribution=)]
    2021-05-18 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1877424, encodeId=994418e74247d, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Thu Apr 28 18:14:22 CST 2022, time=2022-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1068164, encodeId=82ff1068164b6, content=这个颈部吻合口瘘达到30%以上,是认真的吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44ce72633, createdName=wakingday, createdTime=Mon Nov 08 16:57:05 CST 2021, time=2021-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993055, encodeId=a7e5199305538, content=<a href='/topic/show?id=67ab101064b7' target=_blank style='color:#2F92EE;'>#食管切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101064, encryptionId=67ab101064b7, topicName=食管切除术)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKjqGDO7icVKUiaT7urgwXvnvzWtp0fMFU46Xfib8oavFKygiaWtibXReS6ZUh3PImsNicGAwTO5HXxoicnA/132, createdBy=ee262500130, createdName=ms7474195563676018, createdTime=Tue Jul 13 11:14:22 CST 2021, time=2021-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317100, encodeId=1454131e10099, content=<a href='/topic/show?id=df8950505a2' target=_blank style='color:#2F92EE;'>#微创#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50505, encryptionId=df8950505a2, topicName=微创)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437632, encodeId=1a29143e632ad, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589856, encodeId=63341589856ec, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036622, encodeId=44fd103662261, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue May 18 00:14:22 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966432, encodeId=25d09664323c, content=已读,真是受益匪浅呀!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Mon May 17 23:31:30 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966403, encodeId=64ef9664032f, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon May 17 22:01:14 CST 2021, time=2021-05-17, status=1, ipAttribution=)]
    2021-05-17 ms5000000518166734

    已读,真是受益匪浅呀!

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1877424, encodeId=994418e74247d, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Thu Apr 28 18:14:22 CST 2022, time=2022-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1068164, encodeId=82ff1068164b6, content=这个颈部吻合口瘘达到30%以上,是认真的吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44ce72633, createdName=wakingday, createdTime=Mon Nov 08 16:57:05 CST 2021, time=2021-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993055, encodeId=a7e5199305538, content=<a href='/topic/show?id=67ab101064b7' target=_blank style='color:#2F92EE;'>#食管切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101064, encryptionId=67ab101064b7, topicName=食管切除术)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKjqGDO7icVKUiaT7urgwXvnvzWtp0fMFU46Xfib8oavFKygiaWtibXReS6ZUh3PImsNicGAwTO5HXxoicnA/132, createdBy=ee262500130, createdName=ms7474195563676018, createdTime=Tue Jul 13 11:14:22 CST 2021, time=2021-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317100, encodeId=1454131e10099, content=<a href='/topic/show?id=df8950505a2' target=_blank style='color:#2F92EE;'>#微创#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50505, encryptionId=df8950505a2, topicName=微创)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437632, encodeId=1a29143e632ad, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589856, encodeId=63341589856ec, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed May 19 12:14:22 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036622, encodeId=44fd103662261, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue May 18 00:14:22 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966432, encodeId=25d09664323c, content=已读,真是受益匪浅呀!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Mon May 17 23:31:30 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966403, encodeId=64ef9664032f, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon May 17 22:01:14 CST 2021, time=2021-05-17, status=1, ipAttribution=)]
    2021-05-17 wxl882001

    了解

    0

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TAG:内镜下切除术治疗早期食管肿瘤易发生食管狭窄

在过去的20年中,通过内镜黏膜切除术(EMR)或内镜黏膜下剥离术(ESD)进行内镜切除早期食道肿瘤已获得广泛的成功。

JTO: 胸中、下段食管癌的三区域和两区域淋巴结清扫术:一项随机临床试验的长期结果。

食管癌因早期和远处淋巴结转移(LNM)而闻名。在食管癌切除术中进行根治性淋巴结清扫术的目的是减少复发并提高生存率。

NEJM:Nivolumab辅助治疗方案用于晚期食管或胃食管交界癌患者III期临床研究获得成功

对于需接受新辅助放化疗的食管癌或胃食管交界癌患者,nivolumab辅助治疗方案在无病生存期方面显著优于安慰剂

J Gastroenterology: 食管鳞状细胞癌浸润深度与内镜切除术后转移复发的风险之间的关系

内镜下粘膜切除术(ER)是病变局限于食管上皮的食管鳞状细胞癌(ESCCs)的最优的治疗方式。