809例食管贲门癌术后并发症及早期再次手术分析

Analysis of 809 Cases of Common Postoperative Complication of Esophageal-cardial Carcinoma and Early Reoperation

报告809例食管癌、贲门癌手术，术后发生11种共90例并发症，并发症发生率11％。因并发症再次手术17例，死亡3例，再次手术率和死亡率分别为2．1％及17．6％，比一般统计低。对术后因并发症再次手术病例的分析，讨论了吻合口瘘、乳糜胸、血胸、吻合口狭窄和幽门梗阻等并发症的预防和治疗。加强围手术期治疗，重视手术操作是预防并发症的重要措施；胸腔引流、胃肠减压、静脉营养、维持水电解质平衡是保守治疗的主要手段；手术时间和手术方式的选择是再次手术成功的关键。

809 cases of operation on esophageal carcinooma and cardial carcinoma are reported in this paper. Out of the cases there were 90 cases with postoperative complications of 11 kinds, the occurring rate of which was 11％. Within 17 cases of reoperation due to complication 3 cases dead. The reoperation rate and the death rate were 2. 1％ and 17. 6％ respectively. which were lower in comparison with general statistics. On the basis of analysis to cases of reoperation due to postoperative complications, prevention and therapy of the complications such as anastomosing fistula, chylothorax, haemothorax, surgery anastomosis stenosis, pylorus obstruction were discussed. The important precautions for preventing complication were enhancing perioperative therapy and devoting much attention to the operation. The major means for conservative treatment was thoracis cavum drainage, stomach intestine depressurizing, venous nutrition supply, and maintaining the balance of electrolyte. The key to success of reoperation was the proper selection of operation time and operation ways.