食管胃吻合植入套筒法临床应用302例报告

Report of 302 Cases of Esophagogastric Cancer Treated by"Sleeve-like"Esophagogastrostomy

报告１９９１年～１９９５年６月应用食管胃吻合植入套筒法３０２例的临床总结。本术式是在胃前壁（或后壁）无血管区，于胃浆肌层与粘膜下层之间一定范围内分开，食管全层与胃粘膜层吻合，再将胃浆肌层上提，与吻合口上方的食管肌层作两层全周缝合固定，使食管末段植入套叠成筒状的胃壁中，吻合口突入胃腔中。此术式对预防吻合口并发症、吻合口瘘、狭窄和返流性食管炎，取得了良好效果。作者讨论了其预防吻合口并发症的作用机理。

Two hundred and six cases of esophageal or cardiac carcinoma treated with'Sleeve-like' esophagogastrostomy from 1991 to 1995 are reported.The technique used consisted in that the distal end of esophagus was anastomosed to tile mucosa of the stomach through an incision on the anterior or posterior stomach wall where the gastric seromuscular layer was cut and dissected free from the mucosa and then it was sutured to the muscular layer of esophagus 2-3cm higher than the anastomosis.Satisfactory result was achieved. The'Sleeve-like' esophagogastrostomy has the advantages of preventing the commonly seen anastomotic complications: leakage,anastomotic stenosis and reflux esophagitis from occurrance.