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[19例食管癌切除术后并发症再次手术的分析]

[Analysis of 19 cases undergoing reoperation for complications following esophagectomy].

作者信息

Yang Yongbo, Yan Wanpu, Xiong Hongchao, Liang Zhen, Dai Liang, Kang Xiaozheng, Yang Heli, Chen Keneng

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department I( of Thoracic Surgery, Peking Cancer Hospital and Institute, Peking University School of Oncology, Beijing 100142, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2014 May;17(5):492-4.

Abstract

OBJECTIVE

To investigate the cause and the management of treatment and prevention of reoperation following esophagectomy.

METHODS

Clinical data of 946 cases with esophageal cancer undergoing esophagectomy from January 2000 to December 2012 by the same surgical team in the Beijing Cancer Hospital were retrospectively analyzed. Among them, 19 patients underwent reoperation after esophagectomy because of serious complications. Clinical features and treatment course of these 19 cases were summarized.

RESULTS

The indications and procedures of reoperation included thoracotomy for hemorrhage (n=4), diaphragmatic hernia repair (n=4), thoracic duct ligation for chylothorax (n= 4), re-suturing for incision dehiscence (n=4), re-laparotomy and re-thoracotomy for drainage of traumatic pancreatitis (n=1), re-laparotomy for intestinal obstruction (n=1), and tracheotomy for bilateral recurrent laryngeal nerve paralysis (n=1). All the 19 patients were successfully cured without perioperative deaths and further complications.

CONCLUSIONS

The indications of reoperation following esophagectomy include postoperative bleeding, diaphragmatic hernia, chylothorax and abdominal incision dehiscence.

摘要

目的

探讨食管癌切除术后再次手术的原因及治疗与预防方法。

方法

回顾性分析2000年1月至2012年12月在北京肿瘤医院由同一手术团队施行食管癌切除术的946例患者的临床资料。其中,19例患者因严重并发症在食管癌切除术后接受了再次手术。总结这19例患者的临床特征及治疗过程。

结果

再次手术的指征及术式包括开胸止血(4例)、膈疝修补(4例)、胸导管结扎治疗乳糜胸(4例)、切口裂开再次缝合(4例)、再次开腹及开胸引流创伤性胰腺炎(1例)、再次开腹治疗肠梗阻(1例)、气管切开治疗双侧喉返神经麻痹(1例)。19例患者均成功治愈,无围手术期死亡及进一步并发症发生。

结论

食管癌切除术后再次手术的指征包括术后出血、膈疝、乳糜胸及腹部切口裂开。

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