胃粘膜成形食管胃吻合犬形态学观察

Morphological observation on formation of gastric mucosa of esophagogastrostomy in dogs

目的 探讨食管胃吻合抗反流术式 .方法 在犬胃底前壁剥除 8cm× 4 cm浆肌层成形为黏膜管 ,食管黏膜延长约 1 .5cm,与胃部成形黏膜管分层吻合 .分别于术后 7～ 1 80d处死 ,进行大体和组织学观测 ,同深套叠术式对比分析 .结果 实验组成形胃黏膜血供及愈合优于对照组 ;实验组能耐受较高胃内压 ,两组比较有显著性差异 (P<0 .0 1 ) ;突向胃腔内结构厚度值对照组比实验组厚 1倍以上 (P<0 .0 1 ) ;术后食管炎实验组明显低于对照组 (2 /1 3 vs 6/1 1 ,P<0 .0 1 ) .结论 成形黏膜瓣较薄、生长良好 ,在食管与胃压力差作用下关闭性强 。

AIM To probe into the anti reflux of esophagogastrostomy. METHODS At the bottom of gastric anterior wall of dogs, the coat of serosa muscle 8 cm×4 cm was striped to form mucosa tube, and esophagus mucosa was prolonged 1.5 cm, which was anastomosed with mucosa tube formed in the stomach in delamination. The dogs were killed respectively in 7~180 d postoperatively, and observed from the anatomical and histological points of view, the findings of which were compared with that of 'deep intussusception'. RESULTS Blood supply of gastric mucosa formed in the target group was better than that of the control one. Compared with the control group, there was much difference in the tolerance of gastric inner pressure, which was better in the target group in the control group ( P <0.01). The thickness of the structure projecting into the stomach in the target group was more than twice as thin as the control one ( P <0.01). The incidence of esophagitis postoperation in the experimental group was much lower that than of the control group (2/13 vs 6/11, P <0.01). CONCLUSION Mucosa formed by the stomach is thinner, grows well, has a strong ability to open and close under the effect of the pressure disparity between the esophagus and the stomach, and has the good function of anti reflux.