三角平面建立在食管癌根治术防瘘中的应用

Prevention of Postoperative Anastomotic Fistula in Patients with Esophageal Carcinoma by Triangle Plane

目的:探讨在食管癌根治术中胸腔胃近吻合口处建立三角平面以减少吻合口瘘发生。方法:游离食管和胃,食管残端斜行吻合于胸腔胃后壁,形成His角和人工胃底,食管癌根治术后在胸腔胃近端缝合形成一个三角平面,此时吻合口上方已形成"生理性高压区"和His角。结果:30例术后感觉良好,无吞咽及进食后不适,无吻合口瘘的发生。结论:食管癌根治术后在胸腔胃建立三角平面可有效地减少吻合口瘘并发症,提高生存质量。

Objective ： To investigate the triangular plane to prevent the occurrence of anastomotic fistula after radical resection of esophageal carcinoma in the thoracic cavity. Methods： After we freed esophagus and stomach, esophageal stump and stomach were anastomosised in the chest with forming a His angle and an artificial gastric fundus. Then a triangle plane was established on the proximal stomach end after radical resection of esophageal carcinoma. Above the anastomosis there was a ＂physiological high pressure zone＂ and a His angle. Results： Thirty cases had a good feeling after the operation without swallowing and eating difficulties, and occurrence of anasto- motic fistula. Conclusion： The triangular plane can effectively reduce the complications and im- prove the quality of life after the treatment of esophageal carcinoma radical operation.