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目的总结32例食管癌贲门癌切除术后吻合口瘘再次手术治疗的体会,探讨再次手术治疗的方法及依据。方法总结江苏大学附属人民医院32例食管癌贲门癌切除术后吻合口瘘再次手术治疗的临床资料,15例行胸内吻合口瘘修补或重建,17例行左颈部吻合口重建。结果胸内吻合口瘘修补或重建死亡4例,死亡率26.7%,左颈部吻合口重建死亡2例,死亡率11.8%。结论吻合口瘘诊断的早晚影响再次手术治疗方法的选择,早期吻合口瘘可选择修补或胸内吻合口重建,食管癌术后吻合口瘘选择吻合口左颈部重建是较好的方法。
Objective To summarize the experience of reoperation of anastomotic fistula in 32 patients with esophageal and gastric cardia resection and to discuss the method and basis of reoperation. Methods The clinical data of 32 cases of reoperation for anastomotic fistula after resection of esophagectomy and gastric cardia cancer in our hospital were retrospectively reviewed. Fifteen cases were repaired or reconstructed by thoracic anastomotic fistula and 17 cases were reconstructed by left anterior cervical anastomosis. Results Four cases of thoracic anastomotic fistula were repaired or reconstructed, with a mortality rate of 26.7%. Two cases died of anastomosis of the left neck and the death rate was 11.8%. Conclusions The diagnosis of anastomotic fistula affects the choice of reoperation, early repair of anastomotic fistula or anastomotic reconstruction of thoracic anastomosis, and reconstruction of left anterior descending anastomotic fistula after esophagectomy.