食管癌切除后胸内和颈部吻合并发症临床观察  

Clinical observation of complications of thorax and neck anastomosis after esophagectomy

作　　者：缪军[1] 于奇[1] 刘永靖[1] 

机构地区：[1]解放军第105医院胸心外科,安徽合肥230031

出　　处：《安徽医药》2013年第7期1165-1166,共2页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨食管中、上段癌切除后,胸内、颈部吻合并发症发生状况。方法进胸、腹游离食管和胃体,切除食管肿块,根据吻合口部位分为两组,A组334例,吻合口位于胸内,端端吻合;B组253例,吻合口位于颈部,端侧吻合。结果 A组和B组吻合口瘘、胸腔和肺部感染主要并发症分别为87例和48例;两组吻合口瘘分别为46例和21例,两组比较,皆为P<0.05;两组吻合口瘘病死数分别为6例(14.04%)和1例(4.76%),两组比较,P<0.01。结论食管中、上段癌切除后,胸部吻合口瘘、胸腔及肺部感染三大并发症和胸腔吻合口瘘及因瘘而致死者,A组较B组预后差,应尽量采用颈部吻合法。Objective To explore the complications of thorax anastomosis and neck anastomosis after resecting the upper middle esophageal carcinoma.Methods Horacotomy and laparotomy were used to dissociate esophagus and stomach,then esophageal tumors was resected.Cases were assigned into two groups according to the anastomotic site.334 cases for group A,the anastomotic stomas were located inside the thorax and end-to-end anastomosis was applied;253 cases for group B,the anastomotic stomas were located in the neck and end-to-side anastomosis was applied.Results There were 87 cases of anastomotic fistula,thorax and lung infection in group A,while 48 in group B cases.There were 6 and 1 case who died of anastomotic fistula in group A and group B respectivily.There was significant difference in main complications between group A and B（P 0.01）,as well as anastomotic fistula（P 0.05）.Conclusions Thorax anastomotic fistula,thorax and lung infection,the three main complications of oesophagectomy and thorax anastomotic fistula are the major causes of death.It is necessary to adopt the neck anastomosis as much as possible.

关 键 词：食管癌 切除 胸内吻合 颈部吻合 并发症 

分 类 号：R735.1[医药卫生—肿瘤]