吻合口插入——浆肌瓣复盖式食管胃吻合

Esophagogastrostomy covered by sero muscular Valve of Anastomotic Insertion

目的 :预防吻合口并发症 ,提高术后生活质量。方法 :我们对 2 6 3例食管贲门癌患者行食管胃粘膜吻合口插入——“僧帽状”浆肌瓣复盖式吻合术。结果 :术后无吻合口瘘。 0 .5～ 4年随访 ,未见有吻合口狭窄及返流性食管炎。生活质量调查显示 :94.2 %的病人能进普食 ,进食量恢复正常者占 87.4% ,75 .2 %的病人体重有所增加 ,95 .4%的病人能从事一般工作和劳动 ,约有 4.5 %的高位吻合病人右侧卧位时有返酸现象 ,体位改变后症状可完全缓解。结论 :该吻合技术能有效预防吻合口瘘、狭窄和返流性食管炎 ,特别对颈部高位吻合效果更明显 。

Objective:Preventing anastomotic complication and improving patients'living quality after operation.Method:Esophagogastrostomy covered by“mitral” sero muscularvalve of amastomtic insertion has already been performed in 263 cases with esephageal and cardiac carcinomas.Results:Six monthes to one year follow up showed that no stomal leakage nor dysphagia and pyrosis occurred.The barium meal revealed the width of the anastomotic stoma exceeded 0.8～1.5 cm and no reflux.Esophagoscopy revealed no congestion nor edema of mucosa at the stoma.The biopsy of mucosa was normal.The PH Values of lower esophagus ranged from 6.0～7.0 and the intraesophageal acid titration showed negative.The investigation of living quality after operation showed 95.4%(251/263) of all cases can join in works and labour.94.2%(248/263) of patients have eaten full diet.87.4%(230/263) have recovered basically thier the capacity for eating.The regurgitation at right lateral recumbency was 4.5%(12/263),The symptoms disappeared after position change,The weight gain was 75.2%(198/263).Conclusion:It indicates that this new anastomotic procedure is effective in preventing anastomotic leakage、stricture and reflux esophagitis from occurrence and specially beneficial for anastomosis of neck and improving patients'living quality after operation. [