食管贲门癌术后吻合口瘘的治疗

目的 探讨食管贲门癌术后吻合口瘘的合理治疗方法。方法 回顾近年272例食管贲门癌术后发生的15例吻合口瘘临床诊治情况，结合献分析保守治疗或二次开胸手术治疗的合理方法与时机。结果 全组共发生吻合口瘘15例（发生率5.5%）。其中颈部吻合口瘘6例（6.5%），胸部吻合口瘘9例（5.0%）。14例作积极保守治疗、成功13例，死亡1例（作二次开胸手术再瘘死亡）。瘘死亡率13.3%。结论 颈部瘘或胸部瘘估计瘘口较小，感染易控制，以积极的保守治疗为宜，可取得较理想的效果。

Treating postoperative anastomotic fistula of esophagus and cardia carcinoma

Objective To study the treatment of postoperative anastomotic fistula in esophagus and cardia carcinoma. Methods We reviewed 272 cases of esophagus and cardia carcinoma who had undeqone surgical treatment. Results 15 of 272 cases (5.5%) had postoperative anastomotic fistula. Of these 15 patients, 14 cases were treated with conservative therapy and 13 of them were seccessful, one was reoperated and died. Conclusion To treat anastomotic fistula in neck segment and small fistula in thorax segment, conservative therapy was indicafed, while large fistula in thorax segment should be treated with reoperation.