CAJ | 학술논문

目的：总结食管及贲门癌手术少见并发症的诊断及治疗体会，吸取其诊断失误、治疗失败的教训。方法：回顾性分析少见并发症的发病原因、临床诊断、处理方法、预防措施及其中治疗失败的相关因素。结果：治愈及死亡分别为10例及8例（除外已报道的8例）。结论：1）该文所述的并发症虽然少见，但临床上时有发生，若处理不当，常造成严重后果；2）对主动脉食管固有支撕脱性损伤的喷射状出血，术者要沉着、冷静，只要处理方法正确，损伤口均可以修补成功；3）右胸径路是预防奇静脉损伤的关键措施；4）吻合口腹内瘘的患者，若早期漏出感染物包裹于膈下，容易延误诊断；5）吻合口主动脉瘘，关键在于预防；6）警惕术后肺动脉栓塞的发生，提高其防治意识；7）胸胃纵隔疝若不及时处理，预后较差。
목적：총결식관급분문암수술소견병발증적진단급치료체회，흡취기진단실오、치료실패적교훈。방법：회고성분석소견병발증적발병원인、림상진단、처리방법、예방조시급기중치료실패적상관인소。결과：치유급사망분별위10례급8례（제외이보도적8례）。결론：1）해문소술적병발증수연소견，단림상상시유발생，약처리불당，상조성엄중후과；2）대주동맥식관고유지시탈성손상적분사상출혈，술자요침착、랭정，지요처리방법정학，손상구균가이수보성공；3）우흉경로시예방기정맥손상적관건조시；4）문합구복내루적환자，약조기루출감염물포과우격하，용역연오진단；5）문합구주동맥루，관건재우예방；6）경척술후폐동맥전새적발생，제고기방치의식；7）흉위종격산약불급시처리，예후교차。
This study aimed to summarize the diagnosis and treatment of uncommon complications in esophageal and cardiac cancer operations as well as obtain lessons from the failure. Methods:The etiology, clinical diagnosis, treatment, prevention measures, and factors that contribute to the failure of the uncommon complications were analyzed retrospectively. Results: Results showed ten cured cases and eight death cases (except for the reported eight cases). Conclusion:The following conclusions were ob-tained. 1) The complications described in this paper were rare, but they sometimes occur clinically. If wrong treatment was taken, seri-ous consequences would be expected. 2) Once a jet-like bleeding of aortic esophagus avulsion injury occurs, the surgeon must be calm and take proper treatment to successfully patch up the wounds. 3) The right thoracic approach is a new approach to prevent the injury of azygos vein. 4) Patients with anastomotic stoma fistula easily cause a delay in diagnosis if the leakage was wrapped in the inferior phrenic. 5) Taking preventive measures is the key method for the anastomotic aortoesophageal fistula. 6) Occurrence of pulmonary em-bolism after operation should be monitored. 7) Thoracic gastric mediastinal hernia would cause serious consequences if treatment was not taken at a proper time.