Occlusion Treatment of Clinically Symptomatic Leaks of Thoracic Esophageal Anastomoses under Gastroscope_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

周文雄 ,  陈彤宇 , 池浩 , 吴瑶瑶 , 葛文 , 徐建俊 , 周嘉

上海中医药大学附属曙光医院胸心外科（上海 200123）;

Corresponding author：

陈彤宇, Email: tonychen080@sina.com

Keywords：

食管癌; 手术; 吻合口瘘

DOI：

10.7507/1007-4848.20150199

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的总结腔内封堵技术治疗食管癌术后吻合口瘘的应用经验。方法回顾性分析2006年8月至2011年12月上海中医药大学附属曙光医院应用腔内封堵技术治疗食管癌术后吻合口瘘15例患者的临床资料，其中男12例、女3例，年龄47～73岁。分析其临床效果。结果窦道造影证实于瘘口附近有窦道形成者，瘘口直径＜0.5 cm者10例一次堵漏成功；瘘口直径大于0.5 cm者1例，堵漏二次后成功。瘘口附近窦道形成不明显者4例，堵漏均失败。结论腔内封堵技术治疗食管癌术后吻合口瘘有相当的临床效果。瘘口附近有窦道形成是堵瘘成功的关键。

Citation： 周文雄, 陈彤宇, 池浩, 吴瑶瑶, 葛文, 徐建俊, 周嘉. Occlusion Treatment of Clinically Symptomatic Leaks of Thoracic Esophageal Anastomoses under Gastroscope. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(8): 795-796. doi: 10.7507/1007-4848.20150199 Copy

1.	Lam TC, Fok M, Cheng SW, et al. Anastomotic complications after esophagectomy for cancer. A comparison of neck and chest anastomoses. J Thorac Cardiovasc Surg, 1992, 104(2):395-400.
2.	Alanezi K, Urschel JD. Mortality secondary to esophageal anastomotic leak. Ann Thorac Cardiovasc Surg, 2004, 10(2):71-75.
3.	施仁忠, 张亚锋, 夏晓明, 等. 中下段食管癌根治术后胸内吻合口瘘的治疗体会. 临床和实验医学杂志, 2012, 5(9):682-683.
4.	李月明, 丁以国, 陶一勤. 食管癌术后胸内吻合口漏15例治疗分析. 中国误诊学杂志, 2012, 1:192.
5.	张合明. 食管癌、贲门癌术后胸内吻合口瘘13例治疗体会. 肿瘤基础与临床, 2011, 3:245-246.
6.	王启斌. 三管法治愈食管胃吻合口瘘22例体会. 中国实用外科杂志, 1998, 18 (10):637.
7.	刘一胜, 李小平, 贾善浩. 运用"三管法"治疗食管胃胸内吻合口瘘6例体会. 海军医学杂志, 2007, 2:121-123.
8.	陈全德. 红霉素胸膜固定术治疗难治性气胸的研究. 中国医学工程, 2011, 1:81-82.
9.	Hashemzadeh S, Hashemzadeh K, Mamaghani K, et al. Pleurodesis by erythromycin, tetracycline, Aerosil 200, and erythromycin plus Aerosil 200 in a rat model:a preliminary study. Daru, 2012, 20(1):79.
10.	苏梓航, 陈伟光, 杨正心. 食管癌术后吻合口瘘窦道的封堵治疗. 广州医药, 2007, 4:28-30.
11.	Wedemeyer J, Brangewitz M, Kubicka S, et al. Management of major postsurgical gastroesophageal intrathoracic leaks with an endoscopic vacuum-assisted closure system. Gastrointest Endosc, 2010, 71(2):382-386.
12.	Pross M, Manger T, Reinheckel T, et al. Endoscopic treatment of clinically symptomatic leaks of thoracic esophageal anastomoses. Gastrointest Endosc, 2000, 51(1):73-76.
13.	Truong S, Bohm G, Klinge U, et al. Results after endoscopic treatment of postoperative upper gastrointestinal fistulas and leaks using combined vicryl plug and fibrin glue. Surg Endosc, 2004, 18(7):1105-1108.
14.	Maralcan G, Baskonus I, Aybasti N. The use of fibrin glue in the treatment of fistula in a prospective study. Surg Today, 2006, 36(2):166-170.
15.	Francis CW, Marder VJ. Increased resistance to plasmic degradation of fibrin with highly crosslinked α-polymer chains formed at high factor Ⅻ concentrations. Blood, 1998, 71:1361-1363.

1. Lam TC, Fok M, Cheng SW, et al. Anastomotic complications after esophagectomy for cancer. A comparison of neck and chest anastomoses. J Thorac Cardiovasc Surg, 1992, 104(2):395-400.
2. Alanezi K, Urschel JD. Mortality secondary to esophageal anastomotic leak. Ann Thorac Cardiovasc Surg, 2004, 10(2):71-75.
3. 施仁忠, 张亚锋, 夏晓明, 等. 中下段食管癌根治术后胸内吻合口瘘的治疗体会. 临床和实验医学杂志, 2012, 5(9):682-683.
4. 李月明, 丁以国, 陶一勤. 食管癌术后胸内吻合口漏15例治疗分析. 中国误诊学杂志, 2012, 1:192.
5. 张合明. 食管癌、贲门癌术后胸内吻合口瘘13例治疗体会. 肿瘤基础与临床, 2011, 3:245-246.
6. 王启斌. 三管法治愈食管胃吻合口瘘22例体会. 中国实用外科杂志, 1998, 18 (10):637.
7. 刘一胜, 李小平, 贾善浩. 运用"三管法"治疗食管胃胸内吻合口瘘6例体会. 海军医学杂志, 2007, 2:121-123.
8. 陈全德. 红霉素胸膜固定术治疗难治性气胸的研究. 中国医学工程, 2011, 1:81-82.
9. Hashemzadeh S, Hashemzadeh K, Mamaghani K, et al. Pleurodesis by erythromycin, tetracycline, Aerosil 200, and erythromycin plus Aerosil 200 in a rat model:a preliminary study. Daru, 2012, 20(1):79.
10. 苏梓航, 陈伟光, 杨正心. 食管癌术后吻合口瘘窦道的封堵治疗. 广州医药, 2007, 4:28-30.
11. Wedemeyer J, Brangewitz M, Kubicka S, et al. Management of major postsurgical gastroesophageal intrathoracic leaks with an endoscopic vacuum-assisted closure system. Gastrointest Endosc, 2010, 71(2):382-386.
12. Pross M, Manger T, Reinheckel T, et al. Endoscopic treatment of clinically symptomatic leaks of thoracic esophageal anastomoses. Gastrointest Endosc, 2000, 51(1):73-76.
13. Truong S, Bohm G, Klinge U, et al. Results after endoscopic treatment of postoperative upper gastrointestinal fistulas and leaks using combined vicryl plug and fibrin glue. Surg Endosc, 2004, 18(7):1105-1108.
14. Maralcan G, Baskonus I, Aybasti N. The use of fibrin glue in the treatment of fistula in a prospective study. Surg Today, 2006, 36(2):166-170.
15. Francis CW, Marder VJ. Increased resistance to plasmic degradation of fibrin with highly crosslinked α-polymer chains formed at high factor Ⅻ concentrations. Blood, 1998, 71:1361-1363.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Occlusion Treatment of Clinically Symptomatic Leaks of Thoracic Esophageal Anastomoses under Gastroscope

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