食管吻合口瘘治疗新进展

New progression of treatment foresophageal anastomotic leakage

食管吻合口瘘是食管癌术后常见且病死率较高的并发症,其发生的原因复杂,术前预防措施的恰当实施以及术后并发症的有效治疗是降低吻合口瘘病死率的关键。充分通畅引流、抗感染及营养支持是治疗吻合口瘘的基础。食管内支架植入、生物蛋白胶及钛夹的应用为治疗吻合口瘘提供了新的方法,尤其是可降解支架的使用对于吻合口瘘的愈合有较高的成功率,值得进一步深入研究。

Postoperative anastomotic leakage of esophageal carcinoma is a frequent complication with high mortality rate caused by a variety of reasons. Proper preoperative preventive measures and effective postoperative therapy are the main keys to reduce the mortality caused by anastomotic leakage. The treatment basis is fully open drainage,anti- infective and nutritional support. It gives a new way to treat anastomotic leakage by implanting intraesophageal stent and applying fibrin sealing or titanium clip. The use of biodegradable stent for the healing of anastomotic leakage has a higher success rate,and is worthy of further researching.