食管癌术后吻合口瘘(附38例报告)

Anastomotic Leakage after Esophagectomy for Esophageal Carcinoma

本文总结了我院31年间胸科540例食管癌切除术后并发吻合口瘘38例的临床总结分析,发生率为7％,治愈好转28例,占73.6％,提出了吻合口痿的发生原因,在中晚期吻合口瘘中提出保守治疗的措施,充分引流是治疗的关健,营养疗法是治疗的基础。另外也提出早期吻合口瘘二次进胸再次吻合。总之,精细吻合技巧,熟练轻柔的操作,防止术中污染、纠正术前的营养不良状态,严格遵守组织愈合的理论原则,是预防吻合口痿的重要因素。

Of 540 esophagectomies for esophageal carcinoma,anastomotic leakage occurred in 38 (7%).Conservative treatment was undertaken in those of middle or advanced phase of leakage.Ample drainage and nutritional supplement were essential under such circumstances.In the early phase of leakage,re-anastomosis was recommended.Careful manipulation of the anastomosis,protection against surgical contamination and correction of undernourishment status before operation were important factors conducive to prevention of anastomotic leakage.