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胸内吻合口瘘是食管癌术后严重的并发症,病死率高,至今仍是食管外科的棘手难题。我们在采用胸壁开窗术治疗“难治性”脓胸成功的基础上,对胸内食管胃吻合口瘘造成的急性化脓性脓胸采用同法处理,取得一定的效果,介绍如下。胸壁开窗术的范围及大小视瘘口的位置及大小而定,其原则是显露脓腔和瘘口满意。弓上吻合口瘘由于临近胸顶,应选择腋下切口。切除1～3段肋骨、充分蝶化。该术式的优点是:(1)明视下可直接观察脓腔范围;瘘孔大小;感染程度及与周围重要脏器的关系等,
Thoracic anastomosis fistula is a serious complication of esophageal cancer after operation. The high mortality rate is still a difficult problem for esophageal surgery. We used chest wall fenestration in the treatment of “refractory” empyema on the basis of the success of the intrathoracic esophagogastric anastomosis caused by the acute purulent empyema treated with the same method, to obtain a certain effect, as described below. The scope and size of the chest wall fenestration depends on the position and size of the fistula, and the principle is to reveal the abscess and gargle is satisfactory. Anastomosis fistula should be chosen as a result of approaching the chest top. Resection of 1 to 3 ribs, full butterfly. The advantages of this surgical procedure are: (1) The scope of the abscess cavity can be directly observed under visible vision; the size of the fistula; the degree of infection and the relationship with the surrounding vital organs, etc.