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目的 :探讨食管中上段癌经左胸切除后颈部吻合口瘘的发生原因及预防措施。方法 :回顾分析 1 987年 1 0月～ 2 0 0 0年 3月我科 1 33例食管中上段癌经左胸切除术 ,总结胸腔胃经主动脉弓前上提和经食管床、主动脉弓后上提左颈部胃 食管吻合术经验。结果 :1 33例中 ,发生吻合口瘘 8例 ( 6 0 % )、胸胃穿孔 2例 ( 1 5% )、切口感染 4例 ( 3 0 % )、脓胸 1例 ( 0 75% ) ,无手术死亡。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。
Objective: To investigate the causes and preventive measures of anastomotic fistula after the left upper thoracotomy in the upper esophagus. Methods: From January 1987 to March 2004, 33 cases of upper esophageal carcinoma underwent left-sided thoracotomy were retrospectively analyzed. The thoracic stomach was anteroposteriorly elevated and transesophageal bed and the aortic arch was retrospectively reviewed Left neck gastroesophageal anastomosis experience. Results: Among the 33 cases, anastomotic fistula occurred in 8 cases (60%), thoracic gastric perforation in 2 cases (15%), incisional infection in 4 cases (30%), empyema in 1 case (0 75% No surgery died. Conclusion: It is the key to avoid the occurrence of anastomotic fistula by reducing the anastomotic tension, ensuring the entrance of the thoracic cavity and the wide gap after the aortic arch.