目的 探讨经脐切口管状胃制备技术在食管癌根治术中的应用价值,并与传统开放腹部制备管状胃进行比较。方法 回顾性分析2024年1月—2025年1月期间收治的102例接受食管癌根治术的患者,根据不同手术入路方式分为经脐切口组和传统开放组,每组各51例。比较两组患者的手术时间、术中出血量、淋巴结清扫数目、术后疼痛程度评分、术后恢复情况及术后并发症发生率等指标。结果 与传统开放组相比,经脐切口组术中出血量显著减少,术后疼痛评分较低,术后肠功能恢复时间较短,住院时间缩短,差异均有统计学意义（P<0.05）。两组淋巴结清扫总数无显著差异（P>0.05）。经脐切口组切口相关并发症发生率低于传统开放组（P<0.05）;两组吻合口漏、肺部感染、乳糜漏等其他并发症发生率差异无统计学意义（P>0.05）。结论 与传统开放腹部制备管状胃相比,经脐切口管状胃制备技术具有创伤小、术后恢复快、并发症发生率低等优势,且不增加淋巴结清扫范围和术后吻合口并发症,是食管癌三野根治术的安全有效的选择。
Objective To evaluate the clinical value of transumbilical gastric conduit formation in esophagectomy compared with conventional open abdominal approach. Methods We retrospectively analyzed 102 patients who underwent radical esophagectomy for esophageal cancer at our hospital between January 2024 and January 2025. According to different surgical approaches, the patients were divided into a transumbilical group and a conventional open approach group （51 patients in each group）. Operative parameters including surgical duration, intraoperative blood loss, lymph node yield, postoperative pain scores, postoperative recovery, and complication rates were compared between the two groups. Results The transumbilical group demonstrated significantly reduced intraoperative blood loss, lower postoperative pain scores, shorter time to first flatus, and reduced length of hospital stay compared to the conventional open approach group （P<0.05）. No significant difference was observed in the total number of harvested lymph nodes between the two groups （P>0.05）. The transumbilical group exhibited a significantly lower incidence of incision-related complications than the conventional open approach group （P<0.05）. There was no statistically significant difference in the incidence of other complications such as anastomotic leakage, pulmonary infection, and chylous leakage between the two groups （P>0.05）. Conclusion Compared with conventional open abdominal gastric conduit formation, the transumbilical approach offers significant advantages including reduced surgical trauma, accelerated postoperative recovery, and lower complication rates, without compromising lymph node dissection adequacy or increasing anastomotic complications. This approach represents a safe and effective option for esophagectomy.
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