带蒂大网膜移植在胸外科手术的应用

The clinical application of pedicle greater omentum in the treatment of thoracic Surgery

目的：探讨部分难治性胸科疾病手术中应用带蒂大网膜移植的方法及临床应用价值。方法：对31例胸外科手术应用了带蒂大网膜移植在胸部、胸腔相应部位或脏器进行包裹、填塞、插入等不同术式。结果：本组11例食管癌胃代食管、胃食管吻合术病例均在术后第7天进食流质，无吻合口瘘发生；2例肝破裂和3例脾破裂术后无出血，无感染，恢复快；5例支气管胸膜瘘病例术后随诊6月～2年均无支气管胸膜瘘复发；7例慢性脓胸病例术后恢复顺利，3例慢性结核性胸壁脓肿并窦道形成病例术后继续规则抗痨治疗6～12个月，均痊愈出院，随诊9月～3年无复发。结论：带蒂大网膜移植术操作简单，创伤性少，应用于外科治疗胸部软组织缺损等部分胸科疾病及预防手术后并发症可以取得良好效果。

Objective： To evaluate clinical application and method of pediele greater omentum in some thoracic surgery. Methods： 31 patients underwent thoracic surgery by using packing suture, blind tamponade and compression or overlying of pedicle greater omentum from March 2002 to June 2005. Results：The operations were successfully performed with good exposure. There was no operative death, postoperative complication and relapse, the postoperative convalescence was much shortened. Conclusion： Pedicle greater omentum used in some thoracic surgery can get a good efficacy in treating defect of softtissues and in preventing postoperative complications.