Jorgensen J O, Hunt D R
St. George Hospital, Department of Surgery, Sydney, Australia.
Am J Surg. 1993 Mar;165(3):362-4. doi: 10.1016/s0002-9610(05)80844-x.
Suture line leaks after esophageal or gastric surgery are associated with high morbidity and mortality rates. We report a new approach to the management of this problem, which has been used successfully in the treatment of nine patients with such leaks who were treated at or referred to our unit. The suture line defect is first visualized by endoscopy, after which a sump nasogastric tube is advanced down the esophagus and out through the defect into the abscess cavity. The tubes are irrigated intermittently to achieve patency and maintained with continuous suction. Separate pleural or subphrenic collections are drained by conventional techniques. After the injection of contrast down the tube, serial radiologic studies are used to monitor progress and to guide the slow withdrawal of the tube as the cavity collapses.
食管或胃部手术后的缝合线渗漏与高发病率和死亡率相关。我们报告了一种处理该问题的新方法，此方法已成功用于治疗在我院接受治疗或转诊至我院的9例此类渗漏患者。首先通过内镜检查可视化缝合线缺损，之后将一根带引流管的鼻胃管经食管推进并通过缺损处进入脓肿腔。对这些管子进行间歇性冲洗以保持通畅，并持续进行吸引。通过传统技术引流单独的胸腔或膈下积液。经管子注入造影剂后，采用系列影像学检查来监测进展情况，并在脓腔塌陷时指导缓慢拔出管子。
