Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, 359-8513, Japan.
Surg Today. 2012 Jan;42(2):141-6. doi: 10.1007/s00595-011-0049-9. Epub 2011 Nov 18.
Esophageal anastomotic leakage is still a major cause of morbidity and mortality after esophagectomy. We conducted this study to elucidate how anastomotic leakage affects the systemic inflammatory response syndrome (SIRS) criteria.
The subjects of this retrospective study were 61 patients who underwent esophagectomy. We evaluated their preoperative status, the surgical procedures, and postoperative systemic response, including white blood cell count, heart rate, respiratory rate, body temperature, and laboratory data up to postoperative day (POD) 4.
Anastomotic leakage developed in nine patients (14.8%) and was found on POD 7 on average. These patients had a significantly longer hospital stay than those without leakage. Although no difference was observed in postoperative changes of any of the SIRS criteria, the postoperative incidence of SIRS was significantly higher in the patients with anastomotic leakage on POD 4. The number of positive criteria for SIRS was also significantly higher in patients with anastomotic leakage than in those without leakage on PODs 3 and 4.
The SIRS scoring system is valuable for evaluating the severity of systemic inflammatory response caused by anastomosis leakage, and may serve as an indicator for prompt management.
食管吻合口瘘仍然是食管切除术后发病率和死亡率的主要原因。我们进行这项研究是为了阐明吻合口瘘如何影响全身炎症反应综合征（SIRS）标准。
本回顾性研究的对象是 61 例行食管切除术的患者。我们评估了他们的术前状态、手术过程以及术后全身反应，包括白细胞计数、心率、呼吸频率、体温和术后第 4 天（POD）的实验室数据。
9 名患者（14.8%）发生吻合口瘘，平均在 POD7 发现。这些患者的住院时间明显长于无瘘患者。尽管 SIRS 各项标准的术后变化无差异，但吻合口瘘患者在 POD4 发生 SIRS 的发生率明显更高。吻合口瘘患者在 POD3 和 POD4 的 SIRS 阳性标准数也明显高于无瘘患者。
SIRS 评分系统可用于评估吻合口漏引起的全身炎症反应的严重程度，并可作为及时治疗的指标。
