食管癌术后胸胃局灶性坏死的防治

本文报告3例男性食管中段癌患者,食管切除后在主动脉弓上方行食管胃端侧吻合术。术后胸胃发生局灶性坏死,坏死部位均发生在胃底部。 本文讨论了食管切除后胸胃发生坏死的预防,诊断和治疗。作者认为,如胸胃发生局灶性坏死一经诊断,应首先考虑再次手术治疗。

Prevention and Treatment of Gastric Necrosis after Resection of Esophageal Carcinoma

Gastric wall necrosis developed in 3 cases after end-to-side esophagogastrostomy for esophagcal carcinoma. Necrosis should be suspected if patient ran high feverish-ness shortly after surgery accompanied by pneumohydrothorax on roentgenogram and leakage of ingested methylene blue into thoracic cavity. Once the diagnosis is established reoperation should be carried out immediately without delay. Correct operative procedure and meticulous manipulation are the key points in preventing this serious complication from occurrence.