食管癌食管胃手工吻合重建术后吻合口瘘的预防

目的 探讨如何综合预防食管癌食管胃手工吻合重建术后吻合口瘘的方法.方法 统计我院自2001年5月～2006年5月行食管癌食管胃手工吻合重建术524例:本组病例全部采用手工吻合,其中全层吻合加胃浆肌层包埋327例,胃食管斜行套叠吻合141例,食管胃黏膜吻合胃浆肌瓣覆盖56例.结果 全组病例术后仅2例吻合发生口瘘.结论 食管胃手工吻合重建术,只要精心做好围术期处理,提高术中操作技能及吻合口保护,降低切缘阳性率,则可明显减少甚至避免食管胃手工吻合重建术后吻合口瘘的发生.

Prevention of the anastomotic leakage in esophago-gastroplasty by hand in postoperative esophageal carcinoma

Objective To prevent the anastomotic leakage in esophago-gastroplasty by hand in postoperative esophageal carcinoma. Methods Between May 2001 and May 2006,we performed 524 cases of esophago-gastroplasty by handwork anastomosis in postoperative esophageal carcinoma,including 327cases with whole layer anastomosis and gastric seromuscular layer embedding,141cases gastro-esophageal oblique intussusceptive anastomosis,56cases with esophago-gastric mucosa anastomosis covered by gastric seromuscular valve. Results There were only two cases of anastomosis leakage in all cases. Conclusions Anastomotic leakage in esophago-gastroplasty by hand could be prevented by carefully perioperative management and postoperative management,and by improving of anastomotic skills and anastomotic protection ,reducing the positive rate of incisal margin.