252例结肠代食管的临床经验

Colon Replacement of Esophagus: Clinical Experience of 252 Cases

报告２５２例结肠代食管术的临床经验。总并发症率１７．４６％，吻合口瘘发生率１０．３１％。死亡率１．９８％。提高存活率、降低并发症率和死亡率的关键在于：根据结肠血管解剖特征，首选结肠左动脉作结肠段供血管；将结肠段作顺蠕动向移植较符合生理要求；食管和结肠一层吻合安全可靠，炎性反应轻，愈合快；根据病种、病人心肺功能和年龄，选择结肠段的移植径路。

The clinical experience on colon replacement of the esophagus in 252 cases were reported. The over all operative morbidity was 17.46%. The incidence of the anastomotic leak was 10.31%. The operative mortality was 1.98%. The main points of surgical technique were: (1) based on the anatomy of the colon vessels, utilizing the left colic artery as the supporting vessel if possible; (2) using the colon segment in an isoperistaltic position, which proved physiologically better; (3) single-layer anastomosis which was simple and reliable, with minimal inflammation and swift healing; and (4) choosing the channel for the colon transplant according to the disease, the age, and the cardiopulmonary function of the patients.