胸内食管胃吻合口瘘再手术治疗32例  

Reoperation treatment of gastroesophageal anastomotic fistula

作　　者：任正兵[1] 孙斌[1] 陈锁成[1] 

机构地区：[1]江苏大学附属人民医院胸心外科,江苏镇江212002

出　　处：《医药论坛杂志》2011年第2期30-31,35,共3页Journal of Medical Forum

摘　　要：目的总结32例食管癌贲门癌切除术后吻合口瘘再次手术治疗的体会,探讨再次手术治疗的方法及依据。方法总结江苏大学附属人民医院32例食管癌贲门癌切除术后吻合口瘘再次手术治疗的临床资料,15例行胸内吻合口瘘修补或重建,17例行左颈部吻合口重建。结果胸内吻合口瘘修补或重建死亡4例,死亡率26.7%,左颈部吻合口重建死亡2例,死亡率11.8%。结论吻合口瘘诊断的早晚影响再次手术治疗方法的选择,早期吻合口瘘可选择修补或胸内吻合口重建,食管癌术后吻合口瘘选择吻合口左颈部重建是较好的方法。Objective To summarize our experience in the reoperation treatment for gastroesophageal anastom fistula postoperatively,to investigate the methods and foundation for reoperation treatment of gastroesophageal anastomotic fistula. Methods Summarized 32 cases of reoperation clinic data who suffered anastomotic leakage after resection of esophageal and intrathoracic anastomotic fistula repair or reconstruction,and 17 were performed reconstruction of the left cervical anastomosis. Results 4 cases died after intrathoracic anastomotic fistula repair or reconstruction,the mortality rate is 26.7%.2 cases died after reconstruction of the left cervical anastomosis,the mortality rate is 11.8%. Conclusions The period of diagnosis of anastomotic leakage affects the choices of surgical treatments.Early stage of anastomotic leakage can choose repair or reconstruction of intrathoracic anastomotic,reconstruction of the left cervical anastomosis is a best choice for the patients who had the anastomotic fistula after esophagectomy.

关 键 词：食管癌 贲门癌 吻合口瘘 左颈部 重建 

分 类 号：R619[医药卫生—外科学]