食管癌贲门癌术后胸内吻合口瘘防治体会

Prevention and treatment of esophagogastrostomy anastomotic fistula after the operation of esophageal or gastric cardiac cancer

目的探讨食管癌、贲门癌手术后胸内吻合口瘘发生的原因及防治措施。方法回顾性分析12例食管癌术后吻合口瘘患者的临床资料。结果早期瘘及时手术或带膜食管支架封堵,中晚期瘘充分彻底的冲洗引流、肠内外营养支持、全身抗感染治疗,大部分患者得到痊愈。结论造成吻合口胸瘘的原因是多方面的,一旦发生吻合口瘘,选择有效的措施可以提高治愈率。

Objective To investigate the causes,management and prevention for esophagogastrostomy anastomotic fistula after the operation of esophageal or gastric cardiac cancer.Methods The clinical data in 12 patients with postoperative complications of anastomostic leakage were analyzed retrospectively. Results Early fistula could be good by early operation or usage of membrana-covered esophageal stent to cover the fistula.Most patients with middle and late fistula could be completely cured by means of full and thorough washing and drainage, enteral and parenteral nutrition support and systemic anti-infection treatment. Conclusion There were many reasons for the anastomostic leakage and thoracic leakage. Choosing effective measures could improve the cure rate in case of any fistula.