袖套式食管胃吻合——重建贲门术

The Sleeve Esophagogastrostomy for Reconstructed Gastric Cardia

目的：本文介绍一种食管胃吻合的新方法———袖套式食管胃吻合—重建贲门术。方法：该术式在胃端制作带蒂浆肌瓣，呈袖套状包裹吻合口，可防止发生吻合口瘘，利用胃端粘膜层向吻合口内折叠，形成粘膜瓣，可阻止胃液返流。结果：自１９９２年６月～１９９５年１０月，临床已完成１６３例，其中食管癌８４例，贲门癌７９例，术后发生吻合口瘘４例，发生率为２５％。无吻合口狭窄和返流性食管炎发生。结论：该术式设计新颖、先进，使贲门及其功能得以重建。

Objective:The aim of this article was to provide a new method of esophagogastrostomy-the sleeve esophagogastrostomy for reconstructed gastric cardia.Method:A sero muscular flap with pedicle was made at stomach.As a sleeve,it wrappe the anastomotic stoma and may prevent the anastomotic leakage.The gastric mucosa layer was folded towards intracavity of the anastomotic stoma to form a mucosa flap which may prevent the reflux esophagitis.Results:From June 1992 to October 1995,84 cases of carcinoma of esophagus and 79 cases of gastriccardia were operated with the method.4 cases of the anastomotic leakage happened after operation(2.5%).The anastomotic stricture and reflux esophagitis did not occur in all cases.Conclusion:The method was an original design and advanced.The function of gastric cardia was reconstructed with the method.