食管癌切除术后胸胃瘘3例分析

An analysis of 3 cases of intrathoracic gastric leakage afer esophagogastrostomy

目的:探讨食管癌切除术后胸胃瘘发生的高危因素及防治措施。方法:回顾性分析我院2005年-2010年间3例食管癌切除术后胸胃瘘患者的临床资料。3例患者均施行保守治疗,包括禁食,持续胃肠减压,保持胃液引流通畅;抑酸;抗感染;保持胸腔引流通畅,行持续低负压吸引,胸腔灌洗;肠内外营养。结果:患者均瘘口愈合,可进普通饮食。结论:本组3例食管癌切除术后胸胃瘘发生的原因分别为闭合胃残端后未行浆肌层包埋,胃壁缝线过紧过密,局部胃组织缺血坏死穿孔以及颈部吻合致使胃张力过高所致,经保守治疗效果满意。

Objective：To investigate the risk factors,prevention and treatment of intrathoracic gastric leakage after esophagogastrostomy.Methods： The clinical findings of 3 cases of intrathoracic gastric leakage after esophagogastrostomy from 2005 to 2010 were retrospectively analyzed.All 3 patients with intrathoracic gastric leakage were undergone noninvasive treatment including fasting,continuous gastrointestinal decompression,gastric acid secretion suppression,anti-infective therapy,pleural cavity and drainage,enteral nutrition and parenteral nutrition.Results： All three patients with postoperative tintrathoracic leakage were cured by conservative therapy and restarted normal diet without any difficuties.Conclusion： The causes of postoperative intrathoracic gastric leakage were incorrect operative procedures and these complications could be cured with conservative therapy.