CAJ | 학술논문

目的：探讨食管癌术后吻合口瘘与胸廓入口解剖的相关性。方法：回顾分析2012年1月—2014年1月收治的91例采用颈胸腹联合切口行食管癌根治＋胃食管颈部吻合术的患者的临床资料，其中13例患者术后出现吻合口瘘。根据患者术前CT图像上相关间距的测量结果评估胸廓入口解剖结构，分析胸廓入口解剖结构及其他临床因素与术后吻合口瘘的相关性。结果：食管癌术后吻合口瘘与胸廓入口处气管至椎体间距相关，并与肿瘤部位、管状胃形状相关（P＜0．05）。结论：胸廓入口狭小可增加食管癌术后吻合口瘘的发生率，故有必要在术前评估胸廓入口的大小。
목적：탐토식관암술후문합구루여흉곽입구해부적상관성。방법：회고분석2012년1월—2014년1월수치적91례채용경흉복연합절구행식관암근치＋위식관경부문합술적환자적림상자료，기중13례환자술후출현문합구루。근거환자술전CT도상상상관간거적측량결과평고흉곽입구해부결구，분석흉곽입구해부결구급기타림상인소여술후문합구루적상관성。결과：식관암술후문합구루여흉곽입구처기관지추체간거상관，병여종류부위、관상위형상상관（P＜0．05）。결론：흉곽입구협소가증가식관암술후문합구루적발생솔，고유필요재술전평고흉곽입구적대소。
Objective:To explore the relationship and between the postoperative anastomotic leak in esophageal cancer and the anatomy of thoracic inlet .Methods:The clinical data of 91 patients ,who underwent cervical thoracoabdominal incision for radical resection of esophageal cancer combined with cervical esophagogastrostomy ,from January 2012 to January 2014 ,were retrospectively analyzed .13 cases suffered postoperative anastomotic leak .The anatomy of thoracic meatus was evaluated by measuring the related distance in preoperative CT (computerized tomography ) image .Correlation between the anatomy of thoracic inlet together with associated clinical factors and the postoperative anastomotic leak was analyzed . Results:Postoperative anastomotic leak was related to the gap between trachea and vertebral body at the thoracic inlet ,and it was also related to the location of tumor and the shape of tubular gastro (P<0 .05) .Conclusions:Narrow thoracic inlet may increase the incidence of postoperative anastomotic leak in esophageal cancer .Thus ,it’s necessary to evaluate the size of thoracic inlet before operation .