中上段食管癌切除后颈部吻合口瘘的原因及预防

目的探讨中上段食管切除后颈部吻合口瘘的发生原因及预防措施。方法选择我院1998年5月至2007年12月采用食管癌切除胃代食管左颈部吻合术式治疗256例,其中经左胸切除215例,经右胸切除41例。经左胸切除病例胸腔胃均经原食管床主动脉弓后间隙上提至颈部进行吻合。结果256例术后发生吻合口瘘12例,发生率为4.7%;颈部切口感染8例,发生率为3.1%;胸部切口感染3例,发生率为1.2%,均经换药治愈,无手术死亡病例。结论降低吻合口张力,保证胸腔入口主动脉弓后间隙宽畅是避免吻合口瘘发生的关键。

Cause and prevention of cervical anastomotic leakage after mid-upper esophageal carcinoma resection

Objective To discuss cause and prevention measures of cervical anastomotic leakage after mid-upper esophageal carcinoma resection.Methods 256 cases of esophageal carsinoma from May 1998 to Dec 2007 in our hospital were given resection and reconstruction of esophagus with gastric tube through left cervical anastomosis,tumor resection of 215 cases were through left thoracic and gastric tube were lifted from esophagus site to cervicalis through post-aortic inter-space for anastomosis,and 41 cases through right...