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脚内食管胃吻合口瘘是食管、贲门癌切除术后常见的严重并发症,也是手术死亡的主要原因之一,降低胸内吻合口瘘的发生是胸外科医生研究课题之一。我院从1972年以来,对胸内吻合口瘘8例采用二次开胸手术治疗中,发现常用的开放二层缝合法存在不少缺点。我们从1976年改用开放三层(分层)缝合进行食管胃吻合,胸内吻合口瘘的发生率明显下降。本文结合该组病例分析,初步探讨吻合口瘘的预防问题。临床资料我院从1956年4月～1983年3月共收治食管、贲门癌887例,切除683例。胸内吻合650例,术后并发吻合口瘘18例,发生率为2.8％,占术后各种并发症的第一位。颈部吻合33例未包括在内。
Intraorbital esophagogastric anastomotic leakage is a common serious complication after esophageal and cardiac cancer resection, and it is also one of the main causes of surgical death. Reducing the incidence of intrathoracic anastomotic leakage is one of the subjects studied by thoracic surgeons. In our hospital, since 1972, 8 cases of intrathoracic anastomotic leakage have been treated with secondary thoracotomy, and it has been found that there are many shortcomings in the commonly used open two-layer suture method. We switched to an open three-layer (delayed) suture for esophagogastric anastomosis in 1976, and the incidence of intrathoracic anastomotic leakage was significantly reduced. This article combines this group of cases analysis to preliminarily discuss the prevention of anastomotic leakage. Clinical data From April 1956 to March 1983, 887 cases of esophageal and cardiac cancer were treated in our hospital and 683 cases were removed. There were 650 cases of intrathoracic anastomosis and 18 cases of postoperative anastomotic leakage. The incidence rate was 2.8%, accounting for the first postoperative complications. Neck anastomosis was not included in 33 cases.