食管癌手术后胸内吻合口瘘几种处理方法的比较

Comparison of Different Methods Used in the Treatment of Anastomotic Leakage following Resction of Carcinoma of the Esophagus and Cardia of Stomach

本文报告３１例食管胃胸内吻合口瘘的几种处理方法。其中非开胸方法处理２１例，治愈７例，死亡１４例；二次开胸处理１０例，治愈６例，死亡４例，其中采用食管胃插入吻合法５例全部治愈。非开胸组治愈的７例均为术后１０天以上发生瘘者，结合胸内吻合口瘘后的病理生理变化，作者认为二次开胸手术行食管胃再吻合是治疗食管癌术后胸内吻合口瘘的最佳方法。

A variety of methods of treatment for 31 cases of postoperative anastomotic leakage following the resection of carcinoma of esophagus and cardia of stomach from 1980 to 1993 were reported.Among them, 21 cases were treated by conservative methods,and 14 patients died eventually.Ten patients underwent a second thoracotomy,in which 6 cases survived and 4 di ed.In the nonperative group,the time of anastomotic leakage in 7 survivals occurred over 10 deys after operation.The result was not very good in patients who were treated with second thoracotomy.Five patients,however,who underwent Second thoracotomy with insertive esophagogastrostomy were cured.It was suggested that the second thoracotomy should be performed for anastomotic leakage,and that insertive esophagogastrostomy was a better method except in the late and small leakage.