经胸食管横断吻合器再吻合术治疗门静脉高压术后再出血分析

目的回顾性评价经胸食管横断吻合器再吻合术治疗门静脉高压术后再出血的效果。方法应用经胸食管横断吻合器再吻合术在食管下段较低位置阻断食管静脉血流的同时，离断腹段残留或复发的冠状静脉属支。结果本组共11例患者，择期手术9例，急症手术2例，无手术死亡。11例患者均获得长期随访，无再出血或严重并发症发生，于术后1年因肝功能衰竭死亡1例，术后2年1例死于肝癌，其余9例均生存5年以上，5年生存率81．82％（9／11）。结论经胸食管横断吻合器再吻合术适用于门静脉高压术后再出血患者，该手术时间短，止血彻底，预后良好。

Analysis of transthoracic esophageal transection and reanastomosis use the stapler for management of postoperative recurrent bleeding of portal hypertension

Objective To retrospectively evaluate the effect of transthoracic esophageal transaction and reanastomosis use the stapler for management of postoperative recurrent bleeding of portal hypertension.Methods Used the transthoracic esophageal and reanastomosis to make low esophageal transection and transect the intraabdominal residual or recurrent varices of coronary vein in the treatment of recurrent bleeding of portal hypertension.Results In 11 cases of postoperative rebleeding of portal hypertension,9 cases were treated by selective operation,2 cases were treated by emergency operation,witbout postoperative mortality.All the patients received long term follow-up,no patients with bleeding or severe complications,1 cases died of liver function failure in 1 year postoperative,1 cases died of hepatoma in 2 years postoperative,the others existed over 5 years,and the 5-year survival rate was 81.82%.Conclusion The transthoracic esophageal transection and reanastomosis use the stapler is a rational operative method for postoperative recurrent bleeding of portal hypertention.The operation time is short,the hemostatic effect is reliable and the postoperative results are well.