食管癌术后胸胃排空障碍的诊治

目的探讨食管癌术后胸胃排空障碍的病因及其防治。方法回顾性分析47例食管癌术后发生胸胃排空障碍患者的发病原因、临床诊断、处理方法、预防措施等。结果 41例患者经包括介入球囊扩张等在内的保守治疗而痊愈,6例经手术治疗治愈。结论食管癌术后发生的功能性胸胃排空障碍经过非手术治疗即可治愈,而胃扭转等机械性排空障碍应行手术治疗。诊断和鉴别术后胸胃排空障碍的主要方法为消化道造影及胃镜检查。介入球囊扩张术是有效的治疗方法。

Diagnosis and treatment for delayed thoracostomach emptying in post-surgical patients with esophageal cancer

Objective To investigate the cause and prevention for delayed thoracostomach emptying in esophageal cancer patients treated with esophagogastrostomy.Methods A retrospective review of the clinical data of 47 patients suffering delayed thoracostomach emptying among 1231 post-surgieal patients with esophageal cancer from January 2001 to June 2013 were performed.Results Eighteen patients in the 47 patients were cured by conservative managements including balloon dilatation.The remaining 6 patients were treated with surgery.Conclusion The main etiology of delayed thoracostomach emptying is functional.Which can be treated with nonsurgical conservative approaches; whereas mechanical delayed thoracostomach emptying such as gastric volvulus requires surgery.Digestive tract radiography and endoscopic examination is the most important diagnostic approach in identifying and differentiating the etiologies of delayed thoracostomach emptying in post-surgical patients.Balloon dilatation procedure is proved to be effective for the treatment of delayed thoracostomach emptying in post-surgical patients in this study.