颈胸腹三切口食管癌术后无症状吻合口瘘的相关探讨  

Asymptomatic anastomotic leakage after esophagectomy and gastric pull-up

作　　者：张瑞杰[1] 蔡奕欣[1] 张霓[1] 付圣灵[1] 祖育昆[1] 付向宁[1] Rui-Jie Zhang Yi-Xin Cai Ni Zhang Sheng-Ling Fu Yu-Kun Zu Xiang-Ning Fu(Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China)

机构地区：[1]华中科技大学同济医学院附属同济医院胸外科,湖北省武汉市430030

出　　处：《世界华人消化杂志》2017年第11期1002-1005,共4页World Chinese Journal of Digestology

摘　　要：目的总结华中科技大学同济医学院附属同济医院胸外科对三切口食管癌根治术手术方法的改进以及术后无症状吻合口瘘的诊断、处理及预后.方法回顾华中科技大学同济医学院附属同济医院胸外科2014-02/2015-01颈胸腹三切口食管癌根治术患者62例,分析颈部吻合口瘘的发生、诊断、处理及预后.结果62例患者手术顺利,吻合口瘘者7例(11.3%),其中典型吻合口瘘2例(3.2%),无症状吻合口瘘5例(8.1%).愈合时间,典型瘘为14.5 d,无症状瘘为6.4 d.出院后随访半年至1年半,均未见明显吻合口狭窄形成.结论颈胸腹三切口食管癌术后无症状吻合口瘘,愈合快,对病程及患者影响较小,是胃食管吻合技术及围手术期管理方法的改进的体现.AIM To summarize our improvements to the surgical technique of esophagectomy and gastric pull-up and explore the diagnosis,treatment,and prognosis of asymptomatic anastomotic leakage following this surgical technique.METHODS Clinical data for 62 patients who underwent esophagectomy and gastric pull-up at Department of Thoracic Surgery,Tongji Hospital between February 2014 and January 2015 were retrospectively reviewed to analyze the diagnosis,treatment,and prognosis of asymptomatic anastomotic leakage following this surgical technique.RESULTS Seven（11.3%） patients developed anastomotic leakage,of whom five（8.1%） had asymptomatic anastomotic leakage and 2had classical anastomotic leakage.The mean healing time of asymptomatic anastomotic leakage was 6.4 d,and that of classical anastomotic leakage was 14.5 d.All patients were followed for 6-12 mo,and no anastomotic stenosis was observed.CONCLUSION The presence of asymptomatic anastomotic leakage with faster healing time reflects the improvements of the surgical technique of esophagectomy and gastric pull-up.

关 键 词：无症状吻合口瘘 食管切除术 胃引体向上 

分 类 号：R735.1[医药卫生—肿瘤]