全胸段食管切除术后胸胃排空障碍

Thoracic stomach empting disturbance after total thoracic esophagectomy

目的 介绍全胸段食管切除术后胸胃排空障碍的发病原因、诊断、鉴别诊断、治疗及预防,以减少并发症的发生,降低死亡率。方法 我们共完成全胸段食管切除术673例,术后发生胸胃排空障碍8例,结合文献,对该并发症进行讨论。结果 本组8例患者保守治疗、手术治疗各4例,无一例死亡。结论 此并发症的发病原因可概括为胸胃无力、胸胃机械性梗阻和幽门梗阻,手术操作认真、细致、熟练可减少此并发症的发生;尽早诊断,正确处理可降低死亡率。

Objective To introduce the pathogenicity, diagnosis, differential diagnosis, treatment and prevention of thoracic stomach empting disturbance after total thoracic esophagectomy. Methods Six hundreds and seventy three cases underwent total thoracic esophagectomy, and 8 cases of them occured thoracic stomach empting disturbance. We discuss this complication combining the related documents. Results Four cases underwent surgical treatment, and 4 cases with medicine treament. None of them was dead. Conclusion The causes of this compli -cation include gastroparesis, machinery obstruction and pyloric obstruction. The operation should be careful and skillful to decrease this complication. Earlier diagnosis and correct treatment should be given to avoid death.