胃食管机械吻合术后吻合口出血的治疗

目的分析总结胃食管机械吻合术后吻合口出血的治疗经验。方法1990年1月~2007年5月本科共行食管癌、贲门癌切除、胃食管机械吻合术1 106例,其中有8例发生严重的术后吻合口出血,经过保守治疗无效,予以再次开胸探查止血治疗。术中发现出血部位是胃食管吻合口处小动脉活动性出血,予以直视下吻合口全层贯穿间断缝合出血点、止血。结果本组7例痊愈,未发生吻合口瘘、胸胃穿孔等并发症;1例因胃食管吻合口瘘、肺部感染、全身衰竭死亡。结论胃食管机械吻合术后吻合口出血是严重的并发症,尽早诊断,积极手术止血治疗是救治成功的关键。

Clinical treatment of anastomotic bleeding after the surgery of gastroesophageal mechanical anastomosis

Objective To summarize the clinical experience in treatment of 8 patients with gastroesophageal anastomotic bleeding after operation due to the esophagogastrectomy and gastroesophageal mechanical anastomosis.Methods From January 1990 to May 2007,8 patients who occured the severe gastroesophageal anastomotic bleeding among the 1106 patients underwent the surgery of gastroesophageal mechanical anastomosis in our department were re-operated.Results The 7 patients in this group were cured and had not any complications,such as anastomotic leakage,gastric perforation,death and so on;1 patient was dead because of the fistula of gastroesophageal anastomotic and pulmonary infection.Conclusion The gastroesophageal anastomotic bleeding is one of the most serious complications in the surgery of gastroesophageal mechanical anastomosis;It is critical to diagnose and re-operate as early as possible.