带蒂组织修补食管及贲门癌术后吻合区瘘

Preliminary Experience in Immediate Repair of Intrathoracic Esophagogastric Carcinomatous Anastomotic Fistula with Pedicled Tissues

814例食管及贲门癌中手术切除694例,术后发生胸内吻合区瘘16例。其中8例用胸腔引流或其它术式,仅存活2例;8例采用再次开胸带蒂组织修补瘘口,全部治愈。本文叙述手术方法。

From January 1978 to May 1987, resection was carried for 694 out of 814 patients with carcinoma of esophagus and cardia. The Overall resectability rate was 85.2%. There were 16 cases of intrathoracic esophagogastric anastomotic leakage, an incidence of 2.3%. Eigth patients were treated by drainage, feeding jejunostomy or repair of leak, and 2 of them survived, a survival rate of 25% only. The other 8 patients were treated by immediate re-thoracotomy with repair of the leakage using pedicled tissue, and all survived. This method of immediate repair seems to work out well in this small group Of patients and warrants further trial.