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１４９８例食管贲门癌手术并发吻合口瘘分析长治医学院附属医院（０４６０００）苏秦虎，董文忠，赵九恩我科从１９８３年６月至１９９２年１２月共行食管、贲门癌手术１４９８例，在预防吻合口瘘方面有一些体会，现报告如下：临床资料１４９８例中，男１０２４例，女４７４例；年龄最小者１８岁，最大者８０岁；平均５５岁。肿瘤部位：食管上段癌６４例，食管中下段癌４７８例，贲门癌９５６例；采用手工吻合法６０３例，采用消化道吻合法８９５例。１９８３年６月至１９８７年６月共做食管、贲门癌手术４４３例，均为传统手工吻合法（包套式），发生吻合口瘘１６例，占３．６％；１９８７年６月至１９９２年１２月改用机械吻合法与改良手工吻合法，发生吻合口瘘１４例，占１．３％。其中机械吻合法８９５例，发生吻合口瘘１２例；改用手工吻合法１６０例，发生吻合口瘘２例。３０例吻合口屡中死亡１４例，致死率为４６．６％。讨论吻合口瘘是食管、贲门癌切除术后一种严重并发症，国内文献报告发生率为２．１～１１．６％。其致死率为３１．６～７１％［１］。本组１９８３年６月至１９８７年６月吻合口瘘发生率较高，为３．６％；１９８７年６月之后，吻合口瘘发生率为１．３％，较前明显降低。降低
Analysis of 1498 Cases of Esophageal and Cardiac Cancer Complicated with Anastomotic Anastomosis Changzhi Medical College Affiliated Hospital (046000) Su Qinhu, Dong Wenzhong, Zhao Jiuen Our department was involved in 1498 cases of esophageal and cardiac cancer surgery from June 1983 to December 1992. There are some experiences in anastomotic leakage, and the report is as follows: In 1,498 cases of clinical data, there are 1024 males and 474 females; the youngest is 18 years old and the oldest is 80 years old; the average is 55 years old. Tumor sites: 64 cases of upper esophageal cancer, 478 cases of middle and lower esophageal cancer, 956 cases of cardiac cancer; 603 cases using manual anastomosis, 895 cases using digestive tract anastomosis. From June 1983 to June 1987, a total of 443 cases of esophageal and cardiac cancer were performed. All were traditional manual anastomosis (wrapped). Anastomotic fistula occurred in 16 cases, accounting for 3.6%; June 1987 to 1992. In December of this year, mechanical anastomosis and modified manual anastomosis were used, and 14 cases of anastomotic leakage occurred, accounting for 1.3%. There were 895 cases of mechanical anastomosis, 12 cases of anastomotic leakage, 160 cases of manual anastomosis, and 2 cases of anastomotic leakage. In 30 cases of anastomosis, 14 cases died and the lethality rate was 46.6%. Discussion Anastomotic fistula is a serious complication after esophageal and cardiac cancer resection. The incidence in domestic literature is 2.1 to 11.6%. The mortality rate was 31.6 to 71% [1]. The incidence of anastomotic leakage was high in this group from June 1983 to June 1987, which was 3.6%. After June 1987, the incidence of anastomotic leakage was 1.3%, which was significantly lower than before. reduce