食管癌切除术后吻合口瘘的原因及诊治

Reason,diagnose and treatment of the anastomotic leakage after the operation of esophageal cancer

目的:探讨讨食管癌术后发生吻合口瘘的原因、诊断及治疗策略。方法:对于255例食管癌切除术术后食管胃吻合重建患者对的临床资料进行回顾性分析。结果:255例食管癌患者中胸腔内吻合204例,发生吻合口瘘10例,死亡2例;颈部吻合51例,颈部吻合口瘘5例,无1例死亡。结论:吻合口瘘发生原因很复杂,与手术操作、术式、残胃与食管的血运、胸腔感染及全身营养支持等因素有关。采取有效措施,可减少病死率。

Objective： To discuss the reason,diagnose and effective treatment of the anastomotic leakage after the operation of esophageal cancer. Methods： The date of 255 patients with esophageal cancer who were given esophago-gastroplasty were analyzed. Results： Two hundred and four cases out of 255 were received intrathoracic anastomosis,10 patients occured anastomotic fistula and 2 died; while 51 were received cervical anastomosis,5patients occured anastomotic fistula and none of them died. Conclusion： The reason of anastomotic leakage is comprehensive,related to surgical operation,type of operation,blood circulation of esophageal and residual stomach,thoracic cavity infections and nutritional support. It can reduce the death rate by effective measure.