食管癌术后并发症及其处理

食管癌是我国一种常见的消化道恶性肿瘤,居世界癌症死因第7位,中国癌症死因第4位。其中以中段鳞状细胞癌多见,临床表现以晚期进行性吞咽困难为主,确诊主要以胃镜病理活检为金标准,其治疗方法主要有手术、放疗、化疗及分子靶向治疗等。但目前治疗上仍然以手术为主,术前术后放化疗为辅。然而,随着手术在食管癌治疗中适应症的不断扩大、根治性手术淋巴结的扩大清扫及拥有基础疾病高龄患者的增多,术后并发症的发生率不可避免的随之增加。本文将重点阐述吻合口瘘、吻合口狭窄、呼吸及心血管并发症、乳糜胸、胃排空障碍、膈疝、喉返神经损伤及单纯脓胸、严重腹泻、呕血等食管癌术后常见、严重并发症的病因、临床表现与诊断、治疗及其预防。通过对食管癌术后并发症的充分认识及有效预防,从而对食管癌手术成功率及患者术后生存质量的提高、肿瘤预后的改善起到了重要作用。

The Postoperative Complications and Treatment of Esophageal Cancer

Esophageal cancer is a common gastrointestinal malignancies, ranking the world＇s leading cause of cancer death in seven, four of the leading cause of cancer death in China. Which is more common in the middle of squamous cell carcinoma, the main clinical manifestations of late dysphagia, diagnosis gastroscopic biopsy as the gold standard treatment of surgery, radiotherapy, chemotherapy and molecular targeted therapy. But treatment still mainly surgery, preoperative and postoperative radiotherapy and chemotherapy, supplemented. However, with the continuous expansion of the indications for surgery in esophageal cancer treatment, lymph node enlargement and cleaning of radical surgery and elderly patients have underlying diseases increased incidence of postoperative complications inevitably increases. This article focuses on the anastomotic leakage, anastomotic stricture, respiratory and cardiovascular complications, chylothorax, delayed gastric emptying, diaphragmatic hernia, recurrent laryngeal nerve injury and simple empyema, severe diarrhea, vomiting and postoperative esophageal cancer is common, serious complications, etiology, clinical presentation, diagnosis, treatment and prevention. A full understanding of the postoperative complications of esophageal cancer and effective prevention, so as to improve the success rate of esophageal cancer patients survive quality, played an important role in tumor prognosis improvement.