Bardini R, Bonavina L, Asolati M, Narne S, Peracchia A
Department of Surgery, University of Padua, Italy.
Int Surg. 1987 Jul-Sep;72(3):163-5.
Cervical anastomotic leaks occurring in the early postoperative period after esophageal reconstruction are life-threatening complications, with a mortality rate similar to that of intrathoracic leaks if the posterior wall of the anastomosis is affected. Prompt diagnosis and aggressive surgical treatment is vital. The surgical procedures commonly used are often inadequate or unsatisfactory because of the difficulties encountered in the subsequent reconstruction. Twelve patient with an early cervical anastomotic leak following elective esophageal surgery were treated using an original surgical technique which allows diversion and simple delayed reconstruction of the anastomosis without risk of late stricture. Uncontrolled mediastinal sepsis accounted for the three deaths of the series and occurred in patients with a leak of the posterior anastomotic wall in whom definitive surgical treatment was delayed.
食管重建术后早期发生的颈部吻合口漏是危及生命的并发症，如果吻合口后壁受累，其死亡率与胸内漏相似。及时诊断和积极的手术治疗至关重要。由于后续重建中遇到困难，常用的手术方法往往不足或不尽人意。对12例择期食管手术后早期颈部吻合口漏的患者采用了一种原创的手术技术进行治疗，该技术可实现转流并简单延迟吻合口重建，且无晚期狭窄风险。该系列中有3例死亡是由纵隔感染失控所致，发生在吻合口后壁漏且确定性手术治疗延迟的患者中。
