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
YANG Rui
SONG Dong-yang
CUI Peng
WEI Wei
ZONG Liang
QIAO Jun
WANG Nan
WANG Bo
XU Ze-kun
QI Shao-ming
HU Wen-qing
LIU Hui
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.
Keywords：adenocarcinoma of esophagogastric junctionlaparoscopyresection margin positioningintraoperative gastroscopytitanium clip positioning
Publication Date：2024-10-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1155-1158 )