张力性管状胃剪裁技术——管状胃制作改进及优化

Tension gastroplasty approach(TGA)——improvement and optimization of gastric conduit construction

目的:管状胃的制作方法在食管切除术中具有重要意义,探讨一种新的改良技术方法,张力性管状胃剪裁技术(tension gastroplasty approach,TGA)的安全性和可行性。方法:回顾性分析2021年7月四川省肿瘤医院胸外科可手术切除食管癌患者资料,展现张力性管状胃剪裁技术及要点。同时,对管状胃非张力性和张力性剪裁的切缘钉合完整性、黏膜面钉合程度以及有无金属钉外露等方面进行技术优势评价。结果:手术过程顺利,通过临床实践发现,TGA技术实现了切缘钉合完整、黏膜面钉合完全且无金属钉外露的更佳效果。结论:TGA技术能够使胃黏膜面的钉合更为完整,从而实现管状胃浆膜面和黏膜面更好的"双面"成型效果。其有潜力为食管癌患者管状胃制作和手术相关治疗提供更安全、可靠的技术,同时也为进一步改进和优化TGA临床研究打下技术基础。

Objective The creation method of the gastric conduit holds paramount significance in esophagectomy procedures.This study aims to investigate the safety and feasibility of a novel improved technique,the Tension Gastroplasty Approach(TGA),for constructing a gastric conduit.Methods A retrospective analysis of data from patients who underwent surgical resection for esophageal cancer at Sichuan Cancer Hospital in Jul.2021 was conducted.The Tension Gastroplasty Approach and its key aspects were presented.Additionally,a technical assessment was performed comparing the integrity of staple lines at the cut edge of tension-free and tension gastroplasty of gastric conduit,the integrity of mucosal surface stapling,and the presence of exposed metal staples.Results The surgical procedures proceeded smoothly,and clinical practice revealed that the TGA technique achieved superior outcomes in terms of complete staple line integrity,full mucosal surface stapling,and absence of exposed metal staples.Conclusion The TGA technique enhances the more complete apposition of the gastric mucosal surface,thereby achieving a superior"two-sided"molding effect of the serosal and mucosal surfaces of the gastric conduit.It holds the potential to offer a safer and more dependable approach for the construction of a gastric conduit and surgery-related treatments in esophageal cancer patients.Moreover,it lays the technical foundation for further refining and optimizing clinical research on the TGA approach.