食管癌手术死亡原因的探讨

目的为进一步降低手术死亡率，探讨不同时期的食管癌手术死亡原因。方法1984年6月至lop年6月手术切除食管瘤3927例。将前7年和后6年分为A、B两组，对比两组的手术死亡率和死亡原因。结果A组的手术死亡率为3．82％，主要死亡原因是吻合口瘘，占死亡率的50．6％。B组的手术死亡率为2．74％，主要死亡原因是呼吸循环衰竭，占死亡率的87．0％。结论降低手术死亡率的关键是掌握好手术指征，70岁以上合并多脏器疾病的晚期患者要特别慎重。努力提高吻合技术，减少吻合口瘘的发生率。颈部吻合可降低吻合口瘘的死亡率，提高食管癌手术的安全性。

The Variations in the Cause of Death due to the Operation of Esophageal Carcinoma

Objective To the operation mortality and study the cause of death of operation. Metholds From Jun. 1984 to Jun. 1997, 3927 patients with esophageal carcinoma were divided according to the period of operation into two groups (group A 1984-1991, group B 1991-1997), which were compared in the operation mortality and the cause of death of operation. Resuls The operation mortality was 3.82% in group A and 2.74% in group B respectively. The patients in group A died mainly of anastomotic leakage, which covered 50.6% of the total mortality. The patients in groups B died mainly of the exhaustion of breath circulation, which accounted fro 87.0% of the mortality. Conchusions The key of reducing the operation mortality was to master the operation feature, the advanced-stage patients of over 70 yeares old with many viscera diseases, more attention should be paid to. To develop the techique of anastomosis and reduce the incidences of anastomotic leakage. Neck reconstruction' could improve safety in the surgical treatmetn of esophageal carcinoma and reduce the mortality of anastomotic leakage.