食管斜形切除粘膜外翻斜形插入新术式的临床研究(附176例临床报告)

A New Modality of Esophagectomy for Esophageal or Cardiac Cancer

目的 :为了预防食管胃吻合口并发症 ,作者自1987年9月～1997年4月设计一种新术式应用于临床研究。方法 :在肿瘤上方斜形切除食管 ,保留其粘膜层1～1.5cm长 ,且外翻覆盖在肌层上 ,然后将食管端2～2.5cm插入胃腔内 ,用胃切吻合口全层与食管肌层缝合一周 ,并在其上方再包埋缝合一层。结果 :采用此方法连续治疗食管癌、贲门癌176例 ,术后未发生任何吻合口并发症。结论 :本术式在许多关键步骤上有别于传统吻合方法 ,对防止吻合口瘘。

In order to minimize the surgical complications of esophago-gastrostomy in treatment of esophageal or cardiac cancer, a new surgical technique was designed and applied in this hospital from September 1987 to April 1997. The procedure conricted in that the esophagus was slanted above the tumor. The redundant mucosa (1.0～1.5cm) was avested and sutured to the muscular layer of the proximal esophagus. After removal of tumor, the proximal esophagus is inserted into the remnant gastric cavity for 2～2.5cm long. The anastomosis was accomplished by suturing the whole layer of the stomach to the muscular lyer of the esophagus, and was enforced by a layer of sero-muscular sutures. One hundred and seventy-six cases of esophageal and cardiac cancer were treated by this new technique without anastomotic complication occured. The results showed that this method may prevent anastomotic leakage, stricture and reflux esophagitis from occurrance and that it can be popularized clinically.