Viljanto J, Kero P, Erkinjuntti M, Vilkki P
Ann Chir Gynaecol. 1982;71(3):151-5.
Oesophageal anastomotic leakage complicates 5-38% of operations performed for congenital atresia, and continues with prematurity and concomitant anomalies to be a cause of a fatal outcome. After a short review of the diagnostic and therapeutic possibilities of this complication the authors present their own series of 37 consecutive oesophageal atresia and/or oesophagotracheal fistula. Seven of these had anastomotic leakage within 2 to 8 days after operation. Three of them had been primarily operated on through a retropleural approach. The remaining four had had a transpleural approach and were all treated with an immediate rethoracotomy and resuture of the disruption with good primary results. A few cases reported earlier and the authors' present experience support the view that rethoracotomy and resuture of the disruption in transpleurally operated patients provides a method which allows early debridement of the pleural cavity and pulmonary reexpansion, accelerates secondary anastomotic healing and shortens the period needed for pleural drainage and intravenous nutrition.
先天性食管闭锁手术中，食管吻合口漏的发生率为5% - 38%，并且早产和合并其他畸形仍然是导致致命后果的原因。在简要回顾了这种并发症的诊断和治疗方法后，作者介绍了他们连续收治的37例先天性食管闭锁和/或食管气管瘘病例。其中7例在术后2至8天内发生吻合口漏。其中3例最初采用经胸膜后途径手术。其余4例采用经胸膜途径手术，均立即行再次开胸手术，修补破裂处，取得了良好的初步效果。早期报道的一些病例以及作者目前的经验支持这样一种观点，即对于经胸膜途径手术的患者，再次开胸手术并修补破裂处提供了一种方法，该方法可以早期清创胸腔并使肺复张，加速二期吻合口愈合，缩短胸腔引流和静脉营养所需的时间。
