Lerut T, Coosemans W, Decker G, De Leyn P, Nafteux P, van Raemdonck D
Department of Thoracic Surgery, University Hospitals Leuven, Belgium.
Dig Surg. 2002;19(2):92-8. doi: 10.1159/000052018.
Anastomotic complications after esophagectomy continue to be a burden jeopardizing the quality of life and of swallowing. However, incidence, mortality and morbidity of anastomotic complications have substantially decreased in recent years. It seems that this is not so much related to the use of a particular conduit, approach or route for reconstruction, but rather related to refinement in anastomotic techniques and perhaps even more to progress in modern perioperative management. Knowledge of surgical anatomy and meticulous technique are of paramount importance and obviously related to individual expertise. As to the management, most leaks can be treated by conservative measures and reintervention surgery today is rather exceptional. Early endoscopy and dilatation seem to decrease the incidence and severity of anastomotic stenosis.
食管切除术后的吻合口并发症仍然是一个负担，危及生活质量和吞咽功能。然而，近年来吻合口并发症的发生率、死亡率和发病率已大幅下降。似乎这与使用特定的管道、手术入路或重建路径的关系不大，而更多地与吻合技术的改进有关，甚至更与现代围手术期管理的进展有关。手术解剖学知识和细致的技术至关重要，显然与个人专业技能有关。至于管理，如今大多数漏口可通过保守措施治疗，再次手术干预相当少见。早期内镜检查和扩张似乎可降低吻合口狭窄的发生率和严重程度。
