Simi M, Schietroma M, Minervini S, Aloisio F, Leardi S, Recchia C L, Muzi F, Di Marco R, Speranza V
II Clinica Chirurgica Generale e Terapia Chirurgia, Università degli Studi La Sapienza, Roma.
G Chir. 1991 Jun-Jul;12(6-7):385-8.
A series of 12 cases of esophageal anastomotic leakage following esophageal surgery observed from 1969 to 1989 is retrospectively analyzed. In the period 1969-1975 6 patients were treated in emergency and the mortality rate was 66.6%, while the remaining 6 patients observed from 1975 to 1989 were treated conservatively with total parenteral nutrition (sometimes associating adequate surgical drainage): the mortality rate was 16.6%. In conclusion, not only in the treatment of anastomotic leakage, but also in its prevention, artificial nutrition has a crucial role. The outcome of thoracic and abdominal fistulas depends mainly on adequate drainage, not necessarily surgical. Cervical fistulas heal in 2-4 weeks, but strictures arise frequently and respond to endoscopic dilatation.
回顾性分析了1969年至1989年间观察到的12例食管手术后食管吻合口漏病例。在1969 - 1975年期间，6例患者接受了急诊治疗，死亡率为66.6%，而1975年至1989年间观察到的其余6例患者采用全胃肠外营养进行保守治疗（有时联合充分的手术引流）：死亡率为16.6%。总之，人工营养不仅在吻合口漏的治疗中，而且在其预防中都起着关键作用。胸腹部瘘的预后主要取决于充分的引流，不一定需要手术。颈部瘘在2 - 4周内愈合，但经常出现狭窄，可通过内镜扩张治疗。
