结肠段间置胸内吻合术在食管外科中的应用

The use of interposed colon for endothoracic anastomosis in esophageal surgery

目的 研究结肠间置胸内吻合术在食管外科中的应用。方法 对 2 8例食管胸中段、下段癌切除并用GF I型消化道吻合器将带蒂横结肠段与食管进行食管结肠、结肠食管的胸内顺行吻合。结果 保留了食管、胃的迷走神经及完整的食管裂孔和贲门、胃的正常解剖位置。结论 结肠间置胸内吻合术后无胸胃症状 ,消化功能良好 ,无返流性食管炎的发生。 1,3,5年生存率明显提高 ,分别为 96 .4%、92 .8%和 71.4%。

Objective To study the use of interposed colon for endothoracic anastomosis in esophageal surgery.Methods From May 1991 to December 1993, 28 cases were selected with carcinoma of the middle and/or lower segment of esophagus. After tumor resection, a segment of transverse colon with peduncle was anastomosed in its peristaltic direction to the two ends of the severed esophagus. The vagus nerve innervating esophagus and stomach was intact, the anastomical position of the esophagus cardia hiatus and the stomach were preserved.Results No anastomosis leakage, reflux esophagitis or the symptoms caused by the endothoracic stomach occured in this group. The digestive function of the patients remained good. The 1 , 3 , 5 year survical rate was 96.6%, 92.8% and 71.4%, respectively.Conclusion The interposed colon for endothoracic anastomosis is a comparatively ideal method for the reconstruction of esophagus following resection of cancer of mid and lower thind of the esophagus.