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1988年8月~1997年5月,我院经左胸食管癌切除,经食管床食管胃弓上或颈部吻合686例,2例术后胸胃扭转疝入右侧胸腔致排空障碍,均经再次手术证实,现报告如下.例1,男,62岁.1988年8月20日经左胸行胸中段食管癌切除、食管胃颈部吻合术,术中对侧胸膜破裂未予修补,术后7天进食出现胸闷、呼吸困难,呈进行性加重;听诊右侧呼吸音减低,X线检查:胸胃进入右侧胸腔,高度扩张,并见一液平面,钡剂检查在隔食管裂孔处突然中断.置胃管保守治疗1天,复查见胃仍位于右侧胸腔无转复征象.剖胸探查,见胃大弯连同网膜右血管向后扭转270°,复位后缩胃固定,痊愈出院.例2,男,59岁.1997年5月12日经左胸行胸下段食管癌切除,经食管床食管胃弓上吻合,术中对侧胸膜破裂未修补.术后8天进食,出现胸闷、呼吸困难,呕吐大量咖啡色胃内容物,不含胆汁;右背部呼吸音低,胸透示胸胃大部分进入
From August 1988 to May 1997, in our hospital, thoracic esophageal cancer was resected, 686 cases were treated with transesophageal esophagogastric anastomosis or cervical anastomosis, and 2 cases were evacuated into the right thoracic cavity due to chest and stomach twists. All cases were confirmed by reoperation. The report is as follows. Example 1, male, 62 years old. On August 20th, 1988, the left chest was performed for middle and middle esophagectomy, esophagogastric neck anastomosis, and the contralateral pleural rupture was not repaired during the operation. , After 7 days of eating, there was chest tightness and dyspnea, which showed progressive aggravation; auscultation reduced the right breath sounds, X-ray examination: chest and stomach into the right chest, highly dilated, and see a fluid level, tincture examination in the esophagus The hole was suddenly interrupted. The catheter was treated conservatively for 1 day. The review showed that the stomach was still located in the right chest and there was no sign of reversion. The exploratory thoracotomy, see the large curvature of the stomach along with the right blood vessels of the omentum, reversing 270°, and repositioning the constricted stomach. , cured and discharged. Case 2, male, 59 years old. May 12, 1997 by the left chest line of thoracic esophageal cancer resection, esophagus esophagogastric bow anastomosis, intraoperative contralateral pleural rupture was not repaired. Postoperative 8 days Eating, chest tightness, difficulty breathing, vomiting a lot of brown stomach contents without bile; right back breath sounds low, chest thorax showing most of chest and stomach