论文部分内容阅读
目的分析经左胸和胸腹腔镜联合食管癌术后膈疝的发生原因和临床特点,讨论其诊断防治方法。方法回顾性分析10例食管癌术后发生膈疝的临床资料。结果术后早期并发膈疝5例(术后1个月内),远期5例(术后1~11年)。其中1例结肠穿孔,行结肠造口术,术后死于呼吸衰竭;6例经手术治愈;1例放弃手术治疗;2例无明显症状,未予手术治疗。结论食管癌术后膈疝是一种少见而严重的并发症,经左胸径路和胸腹腔镜联合经右胸径路均可发生,其发生与手术操作不当、微创技术的应用导致腹膜粘连减少、术后腹压增加及患者自身体质等因素有关,重在预防,早期诊断、及时手术是防止肠坏死、减少死亡率的有效方法。
Objective To analyze the causes and clinical features of diaphragmatic hernia after thoracotomy and thoracoscopic laparoscopy combined with esophageal cancer and discuss the methods of diagnosis and treatment. Methods A retrospective analysis of 10 cases of esophageal cancer after diaphragmatic hernia clinical data. Results In the early postoperative period, 5 cases were diagnosed as diaphragmatic hernia (within 1 month after operation) and 5 cases (1 to 11 years after operation). One case of colon perforation, colon colostomy, died of respiratory failure after surgery; 6 cases were cured by surgery; 1 case to give up surgery; 2 cases without obvious symptoms, without surgery. Conclusions The postoperative diaphragmatic hernia of esophageal carcinoma is a rare and serious complication. The combination of left breast pathology, thoracic and laparoscopic approach via the right breast path may occur. The occurrence and operation of the diaphragmatic hernia are improper. The application of minimally invasive technique results in the reduction of peritoneal adhesions, Postoperative abdominal pressure and the patient’s own constitution and other factors, focusing on prevention, early diagnosis, timely surgery is to prevent intestinal necrosis and reduce mortality an effective method.