晚期贲门癌切除后食管胃隧道吻合术加胸膜包盖18例

Esophagus-gastric "Tunnel" Anastomoses plus Envelopment with Pleura in 18 Patients after Radical Resection due to Advanced Cardial Carcinoma

目的探讨晚期贲门癌根治术后预防吻合口瘘及吻合口狭窄的方法。方法对晚期贲门癌根治术后采用隧道式吻合加壁层胸膜包盖。结果1998年1月—2004年8月对18例III期贲门癌根治术患者采用此方法,无吻合瘘、吻合口狭窄及手术死亡者。结论这种吻合方法具有以下优点:(1)壁层胸膜粘连愈合力强;(2)对吻合口包盖严密可靠;(3)壁层胸膜可紧贴在吻合口上,不留残腔,可促进粘连。(4)壁层胸膜取材方便。

Objective To study the way to preventing fistula and stricture of anastomotic stoma after radical resection of advanced cardial carcinoma. Methods The patients with advanced cardial carcinoma who had been performed radical resection were operated with esophagus-gastric tunnel anastomoses plus envelopment with pleura in succession. Results None of the 18 patients who were operated in this way suffered from fistula and stricture of anastomotic stoma, and none of them died, either. Conclusion The advantages of tunnel anastomoses plus envelopment with pleura are listed as follows: (1) pleura (parietal layer) have strong adhesive and healing abilities; (2) anastomotic stoma is enveloped tightly; (3) there are no remnant cavities because pleura (parietal layer) cling to anastomotic stoma, which is beneficial to adhesion; (4) pleura (parietal layer) are easy to be utilized.