食管癌术后吻合口瘘的早期诊断课件.ppt

1、1234567LeakDefinitionTreatmentRadiologicalNo clinical signsNo change in managementClinical minorLocal inflammation cervical wound X-ray contained leak(thoracic anastomosis)Fever,WBC,CRPDrain wound Delay oral intakeAntibioticsClinical majorSevere disruption on endoscopySepsisChange management:CT-guid

2、ed drainage(Reintervention)C o n d u i t necrosisEndoscopic confirmationReintervention8910and the French Associations for Surgical Research.Manual versus mechanical esophagogastric anastomosis after resection for carcinoma:a controlled trial.Surgery,1996,120:476831112Intrahospital transport of criti

3、cally ill patients:complications and difficultiesJ.Anaesth Intensive Care，200l，29(4)：400-40513141516171819esophageal resections with Chinese staplers:a retrospective study of 1965 consecutive cases.Chin Med J(Engl),1998,111(10):867-9.20Trastek,et al.Esophageal reconstruction for benign disease:Early

4、 morbidity,mortality and functional results.Ann Thorac Surg.2000;70:1651一1655.21222324频繁剧烈咳嗽，致使胸内压和吻合口内压增高，增加了吻合瘘的机会。2526resection.Ann Thorac Surg.1992 Jun;53(6):1052-6.affecting cervical anastomotic leak and stricture formation following esophagogastrectomy and gastric tube interposition.Am J Surg.1992 May;163(5):484-9.2728293031