上消化道手术后吻合口放射学检查的重要性——一项回顾性队列研究
The importance of radiological controls of anastomoses after upper gastrointestinal tract surgery - a retrospective cohort study.
作者信息
Doerfer Joerg, Meyer Thomas, Klein Peter, Melling Nathaniel, Kerscher Alexander G, Hohenberger Werner, Pelz Joerg Ow
机构信息
Department of Surgery, University of Erlangen-Nuremberg, Germany.
出版信息
Patient Saf Surg. 2010 Nov 11;4(1):17. doi: 10.1186/1754-9493-4-17.
INTRODUCTION
This study was designed to analyze whether routine radiological controls of anastomoses in the upper gastrointestinal tract an early detection of anastomotic leaks.
PATIENTS AND METHODS
135 patients who underwent upper gastrointestinal tract surgery were retrospectively analyzed. Patients in the first group (n = 55) underwent routine radiological control of the anastomoses. In the second group (n = 80) the radiological control was only performed in case of clinical symptoms or signs of anastomotic leaks.
RESULTS
The incidence of anastomotic leaks in the patients seen by us was 5.2%, equivalent to 7 of 135 patients In Group 1 leaks were seen in 4 of 55 patients (7,2%) in group 2 leaks were seen in 3 of 80 (3,8%). The radiological control of the anastomoses with contrast swallow showed the leakage in two cases. Twice the results were false negative. The sensitivity of computed tomography was 100%.
DISCUSSION
Routine radiological control of anastomoses with contrast swallow only has low sensitivity. This procedure should not be performed routinely any more.The radiological control should be used in cases with signs of anastomotic leakage or with postoperatively impaired gastrointestinal passage.
引言
本研究旨在分析对上消化道吻合口进行常规放射学检查是否能早期发现吻合口漏。
患者与方法
对135例行上消化道手术的患者进行回顾性分析。第一组（n = 55）患者接受吻合口的常规放射学检查。第二组（n = 80）仅在出现吻合口漏的临床症状或体征时才进行放射学检查。
结果
我们所观察患者的吻合口漏发生率为5.2%，即135例患者中有7例。第一组55例患者中有4例（7.2%）发现漏，第二组80例中有3例（3.8%）发现漏。用吞钡造影对吻合口进行放射学检查发现2例漏。结果有两次为假阴性。计算机断层扫描的敏感性为100%。
讨论
用吞钡造影对吻合口进行常规放射学检查敏感性低。不应再常规进行此检查。放射学检查应在有吻合口漏迹象或术后胃肠道通道受损的情况下使用。
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