食管癌用国产吻合器行食管胃弓前超胸顶单层吻合术38例

Monolayer anastomosis above chest top in front of aortic arch with domestic anastomose apparatus in treatment of 38 patients with esophageal cancer.

目的:探讨食管癌用国产吻合器在食管胃经主动脉弓前超胸顶单层吻合术中的应用。方法:将胸顶以上食管游离至第一肋水平以上2～3cm,牵拉使胸顶以上食管进入胸腔3～4cm。置入吻合器抵钉座至胸顶以上食管,荷包缝合线下3～5mm处切断食管。胃经主动脉弓前上提,食管残端与胃底后壁最高点吻合,吻合口自动回缩胸顶以上,将胃底向胸顶悬吊缝合约4～5针。结果:38例吻合均一次完成。使用24号吻合器21例,使用26号吻合器17例,无吻合口瘘等严重并发症。X线检查吻合口多位于胸骨切迹上1～2cm。结论:食管癌用国产吻合器行食管胃超胸顶单层吻合术在食管切除长度、减少手术并发症、降低残端阳性率、利于术后放疗等多方面均符合肿瘤外科治疗原则,该术式值得推广。

Objective：To evaluate the efficacy of the monolayer anastomosis above chest top in front of aortic arch with domestic anastomose apperatus in treatment of esophageal cancer. Methods： The cervical esophagus was freed 2-3cm above the first rib. Stomach was advanced through thorax in front of aortic arch. Then esophagus-stomach anastomose was done in cervical with domestic anastomose apperatus. Results ：The anastomosis had been done in 21 cases with No24 apperatus, and 17 cases with No26 ones. No severe complications occured. Anastomose lines were proved at 1-2cm above stenal notch. Conclusion ：The method above mentioned is a safe and feasible procedure with good results, and easy to practise.