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Objective: To summarize esophageal postoperative the anastomotic leakage risk factors, causes and prevention methods. Methods: 317 patients with esophageal cancer resection in our hospital from August 2005 to August 2009 Total purposes, these cases were retrospectively analyzed: (1) might impact the efficacy of esophageal resection select 11 non-repetitive characteristic clinical factors, including gender, age, diabetes, preoperative serum albumin levels, anastomosis, anastomotic site, operative time, preoperative radiotherapy History neck anastomosis ways, whether there is a history of respiratory disease and history of hypertension grouping. The various cases of the above factors information to quantify the assignment, the single factor analysis found that the risk factors of anastomotic leakage; Logistic regression analysis to identify major risk factors for anastomotic leakage influential. ② analysis of the clinical manifestations of anastomotic fistula, CT, endoscopy, the diatrizoate angiography results. ③ occurred at different times and in parts of the anastomotic fistula treatment. Results: The postoperative anastomotic leakage occurred in 17 cases, the incidence of 5.36%, 4 patients died, the fatality rate was 23.53%. With anastomotic leakage analysis identified four factors: neck anastomosis through the retrosternal pathway (OR = 8.990), preoperative serum albumin level less than 35g / L (OR = 7.542), preoperative radiotherapy history (OR = 7.422), respiratory disease (OR = 7.410). According to the fever, chest pain, cough, incision swelling and infection, taking Meilan, diatrizoate contrast can be confirmed, a small number of relatively small fistula needed CT gastroscopy confirm the diagnosis. 9 cases of the second surgery in 17 cases, accounting for 52.9% of anastomotic leakage occurred in cases of early fistula, chest infections the light smaller fistula row of simple repair; fistula underwent surgery during the same period in the late severe chest infection stent placement surgery, cervical esophagus stoma stomach, jejunostomy, open-chest to remove lesions drainage. Surgery stenting for the same period in 4 cases, the cervical esophagus stoma stomach, jejunostomy three cases, simple repair cases, thoracotomy clear lesions, drainage cases, seven cases of cure / 2 deaths, reoperation died rate of 22.2%. Conservative treatment (including simple stenting) 7 cases, accounting for 41.2% of the occurrence of anastomotic fistula cases, 6 patients with simple neck the fistula cases of cured / improved, patients with isolated cases of stent death, conservative treatment mortality 14.3%. Give up the treatment of 1 cases, death. Conclusion: (1) the retrosternal approach the anastomotic fistula percentage esophageal bed path. (2) preoperative radiotherapy, The hypoproteinemia Respiratory a history of risk factors for anastomotic leakage. (3) The neck fistula treatment based on conservative therapy, the prognosis is good; intrathoracic fistula secondary surgery mainly seem to surgery the same period stent surgery prognosis is better.
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