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为探讨食管癌、贲门癌切除术预防吻合瘘的体会 ,对切口选择、保证吻合口血运、吻合方法进行了分析。根据病变的部位和范围选择不同的切口 ,食管吻合缘的游离以 2 .5cm为好 ,食管肌层术中避免挫伤胃壁 ;胃的游离有足够长度 ,确保吻合口无张力 ;遇有吻合不甚满意时 ,可用网膜或胸膜覆盖吻合口。本组 2 0 5例无吻合口瘘发生。提示食管贲门癌术中应注意游离食管和代食管胃肠的血运 ;吻合口张力、吻合技术以及病人营养状况可降低吻合口瘘的发生。
In order to explore the experience of prevention of anastomotic leakage in esophageal or cardia cancer resection, the choice of incision and the method of ensuring anastomotic blood supply and anastomosis were analyzed. According to the location and extent of lesions to choose different incisions, the esophageal anastomosis margin of free to 2.5cm, esophageal muscle to avoid contusion in the stomach wall; gastric free enough length to ensure that the anastomosis without tension; in case of anastomosis When satisfied, the anastomosis can be covered with a mesh or pleura. There were no anastomotic fistulas in this group of patients. Tips should pay attention to esophageal and cardiac cancer surgery free esophagus and esophageal gastrointestinal blood supply; anastomosis tension, anastomosis and patient nutritional status can reduce the incidence of anastomotic leakage.