Delacroix R, Laniez C, Warin B, Delaby J P
J Chir (Paris). 1979 Jun-Jul;116(6-7):411-8.
The authors report five cases of emergency reoperation for breakdown of an intrathoracic oeso-digestive anastomosis.
1 death, 1 failure, new fistula formation but with spontaneous cure within 20 days, 3 primary cures. The success of these reoperations seems to us to depend narrowly: - on the rapidity of diagnosis, facilitated at present by early radiological examination; - on the absolute emergency of reoperation as soon as the breakdown is obvious radiologically and clinically, - on the strictness of surgical technic which should be the same as for a cold operation. Early radiological examination of the digestive anastomoses has permitted better understanding of the mechanisms of the breakdown, emphasising: - firstly, the importance of complete hemostasis; - secondly, the suppression of any dead space around the anastomosis.
作者报告了5例因胸段食管-消化道吻合口破裂而进行急诊再次手术的病例。
1例死亡，1例失败，形成新的瘘口但在20天内自行愈合，3例一期治愈。我们认为这些再次手术的成功在很大程度上取决于：- 诊断的速度，目前早期放射学检查有助于提高诊断速度；- 一旦吻合口破裂在放射学和临床上明显，立即进行再次手术的绝对紧迫性；- 手术技术的严格性，应与择期手术相同。对消化道吻合口进行早期放射学检查有助于更好地理解吻合口破裂的机制，强调：- 首先，彻底止血的重要性；- 其次，消除吻合口周围的任何死腔。
