The Danger Of The Anastomotic Fistula After Esophagectomy Factor Analysis And Processing

Objective: To explore influence of esophageal and cardiac carcinoma postoperative anastomotic healing factors,in order to reduce the occurrence of anastomotic fistula and provide theoretical basis for individualized prevention.Methods: Of 966 patients who underwent resection of esophageal and cardiac carcinoma patients data were retrospectively analyzed,analysis by using analysis method of single factor and multiple factors affect healing anastomosis after resection of esophageal and cardiac carcinoma.Results: Incidence of postoperative anastomotic fistula incidence was 7.03%(68/966),the mortality was 11.76%(8/68),among them the occurring rate of intrathoracic anastomotic fistula was 5.98%(29/485),the incidence of cervical anastomotic fistula was 8.11%(39/481).Preoperative diabetes mellitus,complicated with pulmonary infection after operation,postoperative concurrent pyothorax,postoperative anastomotic fistula incidence is higher than the above complications and complications,the difference was statistically significant(P < 0.05);Intraoperative blood loss is large,the number of lymph node excision bulls high incidence of postoperative anastomotic fistula,the difference was statistically significant(P < 0.05).Postoperative anastomotic fistula surgery there was no statistically significant difference compared with pure conservative treatment(P > 0.05).Compared before and after the processing of anastomotic fistula in 2002,the cure rate of(82.98% VS 47.62 %)and mortality(4.26% VS 28.57 %),the difference was statistically significant(P < 0.05).Comparing 2002 patients before and after onset of symptoms to diagnosis of anastomotic fistula comparison difference was statistically significant(P < 0.05);02 bleeding amount of esophageal and cardia cancer before and after comparison difference was statistically significant(P < 0.05);2002 esophageal and cardia cancer before and after the operation time of comparison difference was statistically significant(P < 0.05).Anastomotic fistula in processing for checking and adjusting the position of chest drainage tube in accordance with the relevant comparative difference was statistically significant(P < 0.05);Enteral nutrition in dealing with the anastomotic fistula using comparative difference was statistically significant(P < 0.05).Conclusions: 1: The preoperative,intraoperative blood loss,the number of lymph node excision with diabetes mellitus,complicated with pulmonary infection after operation,postoperative whether concurrent pyothorax is esophageal and cardia cancer tumor independent influence factors of postoperative anastomotic fistula occurred.2: Early detection,early diagnosis,early treatment to improve the cure rate of postoperative anastomotic fistula,and clear and effective local drainage,full of nutrition support and effective anti-infection are the key to the treatment.