食管癌、贲门癌术后胸胃瘘20例临床分析  

A Clinical Analysis of 20 Cases of Thoracic Gastric Fistulas after Esophagectomy and Cardia Resection

作　　者：丁国文[1] 陈锁成[1] 孙斌[1] 董长青[1] 唐巍峰[1] 施益军[1] 邵爱中[1] 孙扬永[1] 顾海勇[1] 

机构地区：[1]江苏大学附属人民医院,江苏镇江212002

出　　处：《中外医学研究》2012年第32期17-18,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨食管癌、贲门癌术后胸胃瘘的治疗方法。方法:对笔者所在医院20例胸胃瘘患者的治疗进行回顾性分析。早期胃瘘及后期瘘口较大的12例胃瘘进行再次手术,手术方式包括行胃瘘修补术7例,结肠代食管术2例,坏死胃壁及吻合口切除重新吻合2例,1例行扩清术;中晚期胃瘘瘘口较小的8例患者采用保守治疗,包括2例胸腔引流,6例经瘘口内引流。结果:20例患者中有17例治愈出院,3例死亡,死亡率15%。结论:食管癌贲门癌术后胃瘘的治疗方式,根据胃瘘发生的时间、范围而定,术后早期胃瘘及晚期胃瘘较大的病例选用手术治疗,术后晚期胃瘘瘘口小的病例适合保守治疗。Objective ： To investigate the treatment of thoracic gastric fistulas afier esophageetomy and eardia resection.Methods ： Twenty cases with thoracic gastric fistulas after esophagectomy and cardia resection were enrolled in this study.12 cases with early gastric fistula and lager fistula were re-operated. Including gastric fistula repair （7 cases）, colon replace esophagus （2 cases）, re-anastomosis （2 cases） and dissection surgery （1 cases）.8 cases with small fistulas in advanced gastric fistula were treated by conservative treatment.Including thoracic drainage （2 .cases） and fistula drainage （6 cases）.Results ： Seventeen cases were cured, 3 patients died, the mortality rate is 15%.Conclusion ： The treatment of thoracic gastric fistulas after esophagectomy and cardia resection were depend on the time and size of fistulas.Early fistula and large fistula of advanced gastric fistula select operation.large fistula of advanced gastric fistula prefer conservative treatment.

关 键 词：食管癌 贲门癌 胸胃瘘 

分 类 号：R735[医药卫生—肿瘤]