食管癌切除食管胃颈部吻合术后颈部瘘16例分析

Analysis of 16 Cases of Cervical Leakage after the Operation of Esophgeal Cancer

作者等１９８９～１９９５年详细观察和处理食管癌切除食管胃颈部吻合术后颈部瘘１６例，男１０例，女６例。分别发生于术后第４～１５天。其中食管穿孔１例、吻合口瘘１０例和胃壁坏死穿孔５例。胃壁大片状坏死３例、小片状坏死１例、多点状坏死１例。全组均采用保守治疗，１５例治愈，胃壁大片状坏死死亡１例．作者等认为应注意对颈部瘘不同情况的识别，其原因较为复杂。预防应从多方面着手，治疗上强调对胃壁坏死以及严重的吻合口瘘应置负压吸引管引流，同时要警惕瘘入胸内。

Sixteen cases of cervical leakage after esophagogastrosomy were observed between 1989 and 1995.All cases were diagnosed on the 4～15th postoperative day. of the 16 cases, one had esophageal perforation,10 had.anastomotic leakage',5 had necrotic perforation of ther gastric wall.All cases were treated conservatively,with 15 cases cured and one case of death.In these cases with necrosis of gastric wall and severe anastomotic leakage,the low-pressre suction tube should be used selectively.The results indicated that the cause of cervical leakage was very complex and the preventive measures should be taken in many aspects.