食管切除术后吻合口漏：内镜下真空治疗的新治疗选择。
Anastomotic leakage after esophageal resection: new treatment options by endoluminal vacuum therapy.
机构信息
Department of Surgery, University Hospital Campus Grosshadern, Ludwig-Maximilian-University of Munich, Munich, Germany.
出版信息
Ann Thorac Surg. 2010 Nov;90(5):1674-81. doi: 10.1016/j.athoracsur.2010.07.007.
BACKGROUND
Anastomotic leakage after esophagectomy is an important determinant of early and late morbidity and mortality. Control of the septic focus is essential when treating patients with anastomotic leakages. Surgical and endoscopic treatment options are limited.
METHODS
Between 2005 and 2009, we treated 6 patients who experienced an intrathoracic anastomotic leakage after esophageal resection. After all established therapeutic measures had failed, we explored the feasibility of an endoscopically assisted mediastinal vacuum therapy.
RESULTS
We were able to heal intrathoracic esophageal leakages in all 6 patients without any local complications and without the need for reoperation. One patient died because of a progressive pneumonia.
CONCLUSIONS
Endoscopic vacuum-assisted closure of anastomotic leakages may help to overcome the limitations that are associated with intermittent endoscopic treatment and conventional drainage therapy. Our preliminary results suggest that this new concept may be suitable for those patients.
背景
食管切除术后吻合口漏是早期和晚期发病率和死亡率的重要决定因素。在治疗吻合口漏患者时，控制感染灶至关重要。手术和内镜治疗选择有限。
方法
在 2005 年至 2009 年间，我们治疗了 6 例食管切除术后发生胸腔内吻合口漏的患者。在所有既定的治疗措施均失败后，我们探讨了内镜辅助纵隔真空治疗的可行性。
结果
我们能够治愈所有 6 例胸腔内食管漏，无任何局部并发症，无需再次手术。1 例患者因进行性肺炎死亡。
结论
内镜下真空辅助闭合吻合口漏可能有助于克服间歇性内镜治疗和传统引流治疗的局限性。我们的初步结果表明，这一新概念可能适用于这些患者。
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