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吻合口瘘是食管、贲门癌切除,行食管胃吻合术后的严重并发症,死亡率很高,一般在50％以上。近20年来,针对吻合口瘘发生的可能因素,在吻合技术方面不断改进,但多习惯采用两层吻合法。作者根据“对正常与异常食管功能的充分理解是一安全有效的食管手术的先决条件”的理论,认为食管一层吻合对防止吻合口瘘的发生比两层吻合术更合理,并于1989年4月14日为1例食管下段贲门癌患者行食管胃弓下一层吻合术取得成功。术后19天患者康复出院,随访至今已10月,患者饮食正常,体重增加,生活良好。
Anastomotic fistula is a serious complication after esophagogastric anastomosis for esophageal and cardia cancer resection. The mortality rate is high, generally more than 50%. In the past 20 years, the possible factors for the occurrence of anastomotic leakage have been continuously improved in terms of anastomotic techniques, but two-tiered anastomosis is commonly used. Based on the theory that “full understanding of normal and abnormal esophageal function is a prerequisite for safe and effective esophageal surgery”, the authors believe that anastomosis of the esophagus is more reasonable than the two-layer anastomosis to prevent anastomotic leakage, and in 1989 On April 14th, 1 case of esophagogastric lower bow archival anastomosis was successfully performed in 1 patient with lower esophageal cardiac cancer. The patient was discharged from the hospital 19 days after the operation and has been followed up for 10 months. The patient has normal diet, gains weight, and has a good life.