食管癌放疗后并发食管气管瘘15例的外科治疗

目的:探讨食管癌放疗后食管气管瘘的手术疗效。方法:回顾分析我院食管癌放疗后食管气管瘘病例15例,根据不同情况,分别应用:①行食管癌切除、气管瘘口大网膜覆盖修补、胃食管一期吻术。②行食管癌切除、气管瘘口直接缝合加(或)带血管蒂肋间肌覆盖修补、颈部食管旷置、胃造瘘术;二期消化道重建。③行颈段食管闭合外置、贲门闭合胃造瘘术;即胸段食管(含食管气管瘘)旷置术。结果:本组15例,术后死亡2例,死亡率为15.38%,总并发症发生率30.76%。术后1年生存率50%,中位生存期为12个月。结论:食管癌放疗后食管气管瘘的病例,经过积极的术前准备、合理的手术方法以及术后精心的护理,可提高生活质量,减少并发症的发生率,总生存率有改善。

Surgical treatment of 15 tracheoesophageal fistulas secondary to carcinoma of esophagus after radiotherapy

Purpose:To study the effectiveness of surgical treatment of 15 tracheoesophageal fistulas secondary to carcinoma of esophagus a fter radiotherapy. Methods:clinical records of 15 tracheoesophageal fistulas secon dary to carcinoma of esophagus after radiotherapy were analysed.several surgical techniques were analyged for different cases. Results:In all 15 cases, only two of them died,the postoperativ e death rate is 15.38%, and the total complication rate is 30.76%.1-year survi val is 50%, and the median-life span is 12 months. Conclusions:Approriate surgical treatment together with active preoperative preparation, elaborative postoperative nursing care, can improve t he quality of life, reduce postoperative complication rate, and prolong survival .