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目的:探讨食管癌、贲门癌术后胸胃瘘的治疗方法。方法:对笔者所在医院20例胸胃瘘患者的治疗进行回顾性分析。早期胃瘘及后期瘘口较大的12例胃瘘进行再次手术,手术方式包括行胃瘘修补术7例,结肠代食管术2例,坏死胃壁及吻合口切除重新吻合2例,1例行扩清术;中晚期胃瘘瘘口较小的8例患者采用保守治疗,包括2例胸腔引流,6例经瘘口内引流。结果:20例患者中有17例治愈出院,3例死亡,死亡率15%。结论:食管癌贲门癌术后胃瘘的治疗方式,根据胃瘘发生的时间、范围而定,术后早期胃瘘及晚期胃瘘较大的病例选用手术治疗,术后晚期胃瘘瘘口小的病例适合保守治疗。
Objective: To explore the treatment of esophageal and cardiac cancer thoracic fistula after operation. Methods: The author’s hospital 20 cases of thoracic fistula patients were retrospectively analyzed. Early gastric fistula and late fistula larger 12 cases of gastric fistula reoperation, including surgical repair of gastric fistula in 7 cases, colon esophageal surgery in 2 cases, necrosis of the stomach wall and anastomotic resection in 2 cases, 1 line Expansion surgery; in the late stage of gastric fistula smaller 8 patients with conservative treatment, including 2 cases of chest drainage, 6 cases of fistula drainage. Results: Of the 20 patients, 17 were cured and discharged, 3 were killed and the mortality rate was 15%. Conclusion: The treatment of esophageal and gastric cardia postoperative gastric fistula, according to the time and scope of gastric fistula, early postoperative gastric fistula and late gastric fistula larger cases of choice for surgery, late postoperative fistula small fistula The case is suitable for conservative treatment.