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目的探讨食管、贲门癌手术吻合口漏的预防措施。方法对手术治疗食管、贲门癌478例临床资料进行回顾性分析。结果颈部吻合口漏2例,单层吻合,经引流后治愈,胸内吻合口漏13例,二层套入式吻合9例,锯齿状吻合,纵隔胸膜与胃缝合包套吻合口1例,机械吻合3例。2例经再手术治愈,2例因感染衰竭于术后1个月内死亡,其余放弃治疗,吻合口漏发生率3.1%(15/478)。结论加强围手术期处理,采用胃食管锯齿状吻合,纵隔胸膜与胃缝合包套吻合口,可减低吻合口漏发生。
Objective To explore the preventive measures of anastomotic leakage of esophagus and cardia cancer. Methods Surgical treatment of esophageal and cardial cancer in 478 cases of clinical data were retrospectively analyzed. Results The anastomotic leakage in the neck was found in 2 cases with single anastomosis and was cured by drainage. Thirteen cases of anastomotic leakage in thoracic anastomosis, 9 cases of double anastomosis, 1 case of serrated anastomosis, 1 case of anastomosis of mediastinal pleura and gastric suture. , Mechanical anastomosis in 3 cases. 2 cases were cured by re-operation, 2 cases died of infection failure within 1 month after operation, and the rest gave up treatment. The incidence of anastomotic leakage was 3.1% (15/478). Conclusion To improve the perioperative management, gastroesophageal serrated anastomosis, mediastinal pleura and gastric suture anastomosis, can reduce the occurrence of anastomotic leakage.