食管癌术后吻合口瘘与胸廓入口解剖的关系  

Relationship between the Postoperative Anastomotic Leak in Esophageal Cancer and the Anatomy of Thoracic Inlet

作　　者：胥丰恺 卢春来[1] 古杰[1] 赵广垠[1] 葛棣[1] 袁云锋[1] 

机构地区：[1]复旦大学附属中山医院胸外科,上海200032

出　　处：《中国临床医学》2015年第2期165-168,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨食管癌术后吻合口瘘与胸廓入口解剖的相关性。方法:回顾分析2012年1月—2014年1月收治的91例采用颈胸腹联合切口行食管癌根治+胃食管颈部吻合术的患者的临床资料,其中13例患者术后出现吻合口瘘。根据患者术前CT图像上相关间距的测量结果评估胸廓入口解剖结构,分析胸廓入口解剖结构及其他临床因素与术后吻合口瘘的相关性。结果:食管癌术后吻合口瘘与胸廓入口处气管至椎体间距相关,并与肿瘤部位、管状胃形状相关(P<0.05)。结论:胸廓入口狭小可增加食管癌术后吻合口瘘的发生率,故有必要在术前评估胸廓入口的大小。Objective：To explore the relationship and between the postoperative anastomotic leak in esophageal cancer and the anatomy of thoracic inlet .Methods：The clinical data of 91 patients ,who underwent cervical thoracoabdominal incision for radical resection of esophageal cancer combined with cervical esophagogastrostomy ,from January 2012 to January 2014 ,were retrospectively analyzed .13 cases suffered postoperative anastomotic leak .The anatomy of thoracic meatus was evaluated by measuring the related distance in preoperative CT （computerized tomography ） image .Correlation between the anatomy of thoracic inlet together with associated clinical factors and the postoperative anastomotic leak was analyzed . Results：Postoperative anastomotic leak was related to the gap between trachea and vertebral body at the thoracic inlet ,and it was also related to the location of tumor and the shape of tubular gastro （P〈0 .05） .Conclusions：Narrow thoracic inlet may increase the incidence of postoperative anastomotic leak in esophageal cancer .Thus ,it’s necessary to evaluate the size of thoracic inlet before operation .

关 键 词：食管癌根治术 吻合口瘘 胸廓入口 

分 类 号：R655.4[医药卫生—外科学]