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食管贲门癌切除术后发生吻合口狭窄较常见,发生率在0.5-2％左右,近年来应用器械吻合后可达约3-4％,对患者术后影响较大,严重者可衰竭死亡。本文报告食管贲门癌切除术后严重吻合口狭窄采用二次开胸手术治疗4例的体会。手术方法为开胸后找到胸胃,切开胃壁时不能损伤其血运,在胃腔内暴露吻合口,稍加扩张后,环形切除瘢痕组织,食管胃粘膜对拢缝合。这种方法操作简单,损伤小,随访疗效满意。作者还分析了吻合口狭窄发生的原因及防治方法。
Anastomotic stenosis after resection of esophageal and cardiac cancer is more common. The incidence rate is about 0.5-2%. In recent years, anastomoses have reached about 3-4% after anastomosis with the use of an instrument. It has a greater impact on patients after surgery, and severe cases can fail and die. This article reports the experience of using a secondary thoracotomy to treat severe anastomotic stenosis after esophageal and cardiac cancer resection. The surgical method is to find the thoracic stomach after thoracotomy, cut the appetite wall can not damage the blood supply, in the stomach cavity to expose the anastomosis, after a slight expansion, circular scar tissue resection, esophageal gastric mucosa against suture. This method is simple, minimally invasive, and has satisfactory follow-up results. The author also analyzed the causes of anastomotic stenosis and the prevention and treatment methods.