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食管胃吻合术后并发胃梗阻

Obstruction of the Stomach after Esophago-gastric Anastomosis

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【作者】 王弼吴维继倪庆增

【Author】 Wang Bi et al Jiangsu Provincial Oncology Research Institute, Nanjing

【机构】 江苏省肿瘤防治研究所胸外科江苏省肿瘤防治研究所胸外科

【摘要】 本文报道5例食管胃吻合术后并发胃梗阻,发生率0.95%,分析其原因有胃扭转,膈疝,肿大的肝脏压迫幽门部,功能性幽门痉挛。提出了预防和治疗措施。如为机械性胃梗阻,一经诊断明确,应再次手术,解除梗阻原因。如胃扭转可行胃窦部空肠吻合术;如因迷走神经切断后所致胃张力减低及幽门痉挛,可通过保守治疗,一般可自行缓解。本组5例经再次剖腹手术解除胃梗阻原因后,症状消失痊愈出院。

【Abstract】 Obstruction of the stomach following esophagogastric anastomosis occurred in 5 of a series of 416 resections for esophagocardial carcinomas, an incidence of 0.95%. The causes of the obstruction were gastric volvulus(2 cases), hiatus hernia(1 case), compression on the pylorus by an enlarged liver(1 case), and functional pyloric spasm(1 case). As soon as the diagnosis was established, a second operation with careful preoperative preparation was carried out successfully to relieve the obstruction. The cases of gastric atony and pyloric spasm were treated conservatively. All the 5 cases were relieved of obstruction and were symptom-free on discharge.

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