| Objective: To investigate the clinical effect of endoscopic internal drainage in the treatment of gastroesophageal anastomotic fistula.Methods: A retrospective analysis of 50 cases of of gastroesophageal anastomotic fistula was implemented from January 2010 to January 2016 in Qingzhou City People’s Hospital and Yidu Central Hospital.The 50 patients were diagnosed and confirmed as thoracic esophageal cancer and cardia cancer in gastroesophageal anastomotic fistula by the way of oral methylene blue,upper gastrointestinal iodine oil radiography and gastroscopy,but must exclude the following cases: Patients with esophageal cancer and cardia cancer after surgery of severe pulmonary infection or chylothorax occurred.The selected 50 patients were randomly divided into control group and treatment group,the control group of 23 patients,the patients of treatment group were 27.The control group include 15 men and8 women;aged 41-77 years,mean age(53.20 ± 1.36 years),esophageal cancer in 16 cases,cardia cancer in 7 cases.Treatment group: male: 16 cases,female:11 cases;aged 42-76 years,mean age(52.83 ± 1.27years),esophageal cancer in 21 cases,cardia cancer in 6cases.The selection of patients in the surgical approach,the general situation is basically the same,the difference is not significant(P > 0.05).Two groups of patients were treated with drainage,intravenous nutrition,gastrointestinal decompression and antibiotic resistant infections and other conservative treatment,the treatment group of patients with conservative treatment on the basis of the above combined with endoscopic biliary drainage treatment,and daily repeated washing with saline,and finally into the sensitive antibiotics.At the same time,with the gradual reduction of the cavity around the fistula and the drainage catheter.Finally,the daily withdrawal of exudate was less than 5ml,the color was clear,no pus and floc.to pull out the catheter in under gastroscope,The internal fistula of the anastomotic stoma was clamped or sprayed with OB glue under gastroscope.The two groups were observed in clinical drainage catheter time,fistula closure time,gastroesophageal anastomosis fistula cure rate and the incidence of complications in patients,compared with clinical curative effect,hospitalization time,medical cost and satisfaction of two groups.Results: The anastomotic fistula closure time and intubation time of patients in the treatment group were shorter than those of the experimental group,the clinical cure rate and improvement rate of patients in the treatment were higher than those of the control group,and the incidence of complications of patients in the treatment group was significantly lower than that of the control group,there were statistically significant differences in clinical data,(P<0.05);The hospitalization time and hospitalization expenses of patients in the treatment group were significantly lower than those of the control group with anastomotic fistula,the medical treatment satisfaction and praise degree of patients in the treatment were significantly higher than those of the control group,there were statistically significant difference in clinical data(P<0.05).Conclusion: The clinical curative effect of the treatment of chest tube drainage of gastroesophageal anastomotic fistula in exact endoscopic device,can significantly reduce the patients with anastomotic fistula closure time,improve the cure rate,reduce the patients with tube time,complication rate and hospitalization time,reduce medical costs of patients,improved medical satisfaction and quality of life of the patients.The method is simple,less trauma,easy to accept by patients,high clinical practical value,is conducive to the complete recovery of patients with anastomotic leakage,it is worth popularizing in clinical use. |
