食管癌致食管或胸胃气管瘘的外科治疗.pdfVIP

20 10 2 17 1 Chinese Journal of Clinical Medicine,20 10. Vol. 17, No.1 37 # # 张绍明 徐小平 张 珩 才志刚 吴海波 信德和 (解放军455 医院心胸外科, 全军胸部肿瘤诊疗 心, 上海 200 052) 目的:探讨食管或胸胃气管瘘的手术治疗方法及效果方法: 对19 例食管气管瘘和5 例食管癌术后胸胃气管瘘病例的 临床资料结果:本组患者根据瘘的性质及手术危险因素的不同,分别选择了: ¹ 食管癌切除气管瘘口修补消化道重建术; º 食管或胸胃气管瘘切除,瘘口分别修补术; » 食管气管瘘旷置胃造口 术 3 类手术围手术期死亡 2 例, 病死率 8. 33 %, 术后总并发症发生率29 .16%; 术后1 年生存率50%, 位生存期 15 个月结论:在积极的术前准备, 合理的选择病例, 并针 对性的选择合理的外科治疗策略,可使食管癌所致食管气管瘘的病例获得生存优势 食管气管瘘; 胸胃气管瘘; 外科治疗 R73 5. 1 A Preliminary Experience on the Surgical Treatment of Esophageal Cancers-Induced Tracheoesophageal Fistula and Tracheo-Gastric Conduit Fistula ZH A N G S haom ing X UX iaop i ng ZH A N G H e ng CA I Zh ig ang W U H a ibo X I N D ehe D ep ar tment of Card io-T hor acic S ur g er y Ch i nese P eop l ecs L i ber ati on A r my 455th H osp it al Shang ha i 2000 52 Chi na Abstract Ob ective:To explore the ethods and effects of different surgical treat ents of tracheoesophageal fistula and tra- cheo-gastric conduit fistula. Methods: This report retrospectively analyzed 19 cases of tracheoesophageal fistula and 5 cases of tracheo-gastric conduit fistula after the esophagecto y.Results: According to the condition of the fistula and the operative risk factors, three surgical ethods were adopted three types of surgery. (1)Esophagecto y, tracheoplasty to repair thefistula and type I or type II digestive tract reconstruction. (2) Respectively transect and repair the esophageal/ gastric conduit fistula and the tracheal fistula. ( 3) Esophageal bypass in tracheoesophageal fistula and gastrosto y, or gastricbypass with esophageal ex- clusion. A ong those 2 4 cases presenting to our hospital, 2 patients ( 8. 33 %) died during the post-operative period. A ong the 2 2