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[目的]探讨272例食管贲门癌术后吻合口瘘发生的原因及减少其发生的措施。[方法]回顾分析近年经治的272例食管贲门癌术后发生吻合口瘘的病人术前状态 ,围术期处理及手术方式 ,探讨相关因素。[结果]全组272例食管贲门癌手术后并发生吻合口瘘15例(发生率5 5%) ,其中颈部吻合口瘘6例 ,胸部吻合口瘘9例 ,死亡2例(瘘死亡率13 3 %)。患者营养状态及手术操作与吻合口瘘发生密切相关。[结论]重视手术操作规范技巧 ,合理的围手术期处理是预防食管贲门癌术后发生吻合口瘘的关键所在。
[Objective] To investigate the causes of postoperative anastomotic fistula in 272 patients with esophageal and cardiac cancer and the measures to reduce their occurrence. [Methods] Retrospective analysis of 272 cases of esophageal and cardiac cancer in recent years after operation of anastomotic leakage occurred in patients with preoperative state, perioperative management and surgical approach to explore the relevant factors. [Results] A total of 272 patients with esophagectomy and cardia cancer developed anastomotic fistula in 15 cases (the incidence rate was 5 5%). Among them, 6 cases were anastomotic fistula, 9 anastomotic fistula and 2 died (fistula mortality rate 13 3%). Patients with nutritional status and surgical operation and anastomotic leakage are closely related. [Conclusion] Emphasis on surgical procedures and techniques, rational perioperative management is the key to prevent anastomotic fistula after esophageal and cardiac cancer operation.