胃浆肌瓣覆盖式食管胃吻合术的临床应用

Clinical applicalion of esophagogastrostomy encircled by sero-muscular gastric wall flap

为预防食管胃吻合口的并发症，我们设计一种新的吻合方法，即胃浆肌瓣覆盖式食管胃吻合术。采用新吻合方法行食管贲门癌切除术120例，贲门失弛缓症食管部分切除术42例，手术无死亡，术后未发生吻合口瘘。术后半年内38例行头低脚高位食管钡餐检查，吻合口为2.0～2.2cm者6例，1.5～2.0cm者30例，1.0～1.5cm者2例，未见返流现象。术后半年至3年行食管镜检和活检30例中，食管粘膜正常者28例，仅2例有轻度粘膜充血水肿。认为此方法有实用价值。

A new operative procedure-esophagogastrostomy encircled by sero-muscular gastric wall flap was designed by the authors in order to prevent anastomotic complication. One hundred and twenty cases of esophageal and cardiac cancer and 42 cases of cardiospasm were treated with the new operative procedure. There is no death. There is no postoperative esophagogastric anastomotic leakage in these cases. After operation in 38 patients examined by esophagoraphy in a trendelenburg,s position, the width of the anastomotic stoma ranged from 2. 0 to 2. 2cm in 6 cases, 1. 5 to 2. 0cm in 30 cases, 1.0 to 1. 5cm in 2 cases, and no reflux in formation occurred. Esophagoscopy and biopsy in 30 patients, reveated normal esophageal mucosa in 28, Slight reddenting and swelling in 2. The authors believe that the new anastomotic procedure is highly justifiabIe and of practical value.