保留贲门的食管端端吻合术临床外科探讨

Clinical approach of end-end anastomosis of the esophagus with preservation of the gastric cardia

本文报道保留贲门食管端端吻合术166例,临床结果表明手术方法应用方便、可靠,对防止食管狭窄,吻合日瘘、返流性食管炎等并发症有良好作用。食管端端吻合作者主张横断食管时其粘膜超出肌层约0.2至0.3cm,粘膜下毛细血管网丰富,有支撑保护肌层的作用,故无论全层或粘膜对粘膜,肌层对肌层缝合,吻合缝针较常规吻合要少,缝合面平整无缺,利于愈合。

This paper reports end-end anastomosis of the esophagus with preservation of cardia in 166 patients.The results demonstrate that it not only has the adventages of safety and convenience, but also is an effective for preventing striture of the esophagus,anastomotic leakage and reflux esophagitis.The authors believe that the esophageal mucosa should be transsected 0.2～0.3cm longer than its musclar coat when the esophgus is resected.Because the rich capillary network in the submueosa of esophagus affords a protection for its muscular coat,the stitches should be less in number and its section after stiching would be smooth and left no defect when the anastomosis is performed.In this way,stoma healing would be cnhanced.