微创外科综合治疗食管破裂疗效分析  

Therapeutic effects of comprehensively minimally invasive surgical operation for esophageal rupture and review of related literature

作　　者：黄麟[1] 郑斌[1] 陈椿[1] 郑炜[1] 朱勇[1] 郭朝晖[1] Huang lin Zheng Bin Chen Chun Zheng Wei Zhu Yong Guo Chaohui(Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350000, Chin)

机构地区：[1]福建医科大学附属协和医院胸外科,福州350000

出　　处：《中华胸部外科电子杂志》2017年第2期83-86,共4页CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition

摘　　要：目的探讨运用微创手术综合治疗食管破裂的疗效。方法回顾性分析福建医科大学附属协和医院胸外科2013年1月至2016年4月收治的10例食管破裂患者的临床资料,经胸部X线、胸部CT、上消化道造影或胃镜确诊。除2例行内科对症处理外,1例行胸腔镜下食管切除术及消化道重建术,7例行胸腔镜下Ⅰ期修补术,术后均综合引流及内科对症处理。平均手术时间(255.6±19.4)min,术中出血量(100.6±15.5)ml,引流时间(27.5±5.6)d,术后恢复经口进食时间(43.7±4.2)d。结果1例行胸腔镜下食管切除术及消化道重建术患者痊愈出院;7例行胸腔镜下Ⅰ期修补术患者中,痊愈5例,1例突发呼吸心脏骤停死亡,1例死于呼吸功能衰竭。结论仔细评估患者病情后行微创外科综合治疗食管破裂是可行的,甚至针对晚期行Ⅰ期修补的患者也是安全、有效的。Objective To explore the therapeutic effects of comprehensively minimally invasive surgical operation for esophageal rupture. Methods From January 2013 to April 2016, 10 cases of esophageal rupture were diagnosed by chest X rays, chest CT scan, upper gastrointestinal contrast and gastroscopy in our department and clinical data were analyzed retrospectively, including 6 patients of spontaneous esophageal rupture, 1 patient of foreign body esophageal rupture and 1 patient of traumatic esophageal rupture. Among those patients, 7 cases were treated by stage I VATS repair surgery and 1 case was treated by VATS gastroesophageal anastomosis of esophagus resection, which combined with surgical drainage and medicine cure, except 2 cases were treated by just only medicine cure. Mean surgical time was （255.6± 1 9 .4 ） min. Average intraoperative blood loss was （100. 6 ± 15. 5） ml. The time of surgical drainage was （2 7 .5 ±5. 6） d and postoperative recovery time （4 3 .7 ± 4 .2 ） d. Results For all patients,a cure rate of 7 5 ,0% （6 /8 ） was achieved by surgical operation, 1 case treated by VATS gastroesophageal anastomosis of esophagus resection was recovered and discharged from the hospital; among 7 cases who underwent stage I VATS repair surgery, 1 case recovered, 1 case died of sudden cardiac arrest and another died of respiratory failure. Conclusions After evaluating condition of patients,comprehensively minimally invasive surgical operation for esophageal rupture is feasible, safe and effective, especially patient in end-stage treated by stage I VATS repair surgery.

关 键 词：食管破裂 微创 消化道重建术 修补术 

分 类 号：R655.4[医药卫生—外科学]