1 case of anastomotic leakage after esophagectomy re-tube care.docVIP

 PAGE \* MERGEFORMAT 7 1 case of anastomotic leakage after esophagectomy re-tube care [Keywords:] Esophageal cancer; fistula; Care Esophageal cancer is common in China, the main treatment is surgical excision. After the most serious complication is anastomotic leakage, high mortality, and postoperative gastric tube and feeding tube pulled mistake to increase the incidence of anastomotic leakage. reported in recent years abroad anastomotic leakage was 2.6% -6.4% [1]. early detection and effective treatment and careful nursing, the healing of anastomotic leakage and the rehabilitation of patients is essential. A medical record Female patient, 52 years old, 40 kg, 2 more than a month eating obstruction, endoscopy showed the middle esophagus, in the July 14, 2009 admission, after adequate preoperative preparation, on July 17 in the trachea under general anesthesia middle esophageal cancer resection. after 24 h, enteral nutrition, inhalation 2 times a day, the 4th day after X-ray showed lung expansion given closed thoracic drainage tube removal. 4 patients on the evening of their own nasal gastric tube and the removal of intestinal feeding tube the next day in the X-ray tube under the given replacement. 8 patients with postoperative fever, cough, chest tightness, heart rate 90 beats / min, esophageal swallowing meglumine, CT show iodine mediastinal water, the limitations of right upper lung fluid pneumothorax confirmed anastomotic leakage. emergency line of the right thoracic cavity closed drainage, and in the X-ray tube under the reset recovery Cary. After decompression, the chest closed drainage, enteral nutrition input and effective antibiotic treatment, fever control after 16, auscultation, breath sounds clear lungs, CT showed pleural effusion product gas disappears, the chest drainage tube without liquid and gas extraction, the removal of chest lead tube. after 20 days, disable the gastrointestinal decompression tube, disable intravenous antibiotics