食管置入吻合术117例

THE ESOPHAGEAL INSERTION ANASTOMOSIS PROCEDURE IN 117 CASES

本文报告117例食管癌、贲门癌切除术后应用改进的食管置入吻合法,进行食管重建术的体会,疗效满意。本组术后吻合口瘘1例(0.8％),死于术后ARDS1例(0.8％)。无吻合口狭窄及反流性食管炎现象。本术式是将食管残端从胃壁切口插入、胃壁切口缘缝合固定于食管壁外侧,吻合口在主动脉弓下的用游离后左下肺韧带包绕,而在主动脉弓上的用吻合部邻近大网膜包绕。其优点是减少或防止吻合口瘘、狭窄及反流性食管炎的发生。

117 cases of carcinoma of the esophagus and gastric cardia, underwent improved esophageal insertion anastomosis after surgical resection of the tumor, and performed the reesetablishment of the esophagus were reported.Inthis group : I case (0.8%) had anastomotic leak, I case (0.8%) died of postoperative ARDS, no anastomotic stricture and reflux esophagitis occurred. The operative procedure was the hsertion of esophageal remnant, which passed through the incision of stomach wall into the stomach.The cutting edge of the stomach wall was sewed up and fixed on the lateral side of the esophagus. One part of the anastomotic cut, which was situated under the aortic arch was wrapped, with dissociated left lower pulmonary ligament; and the other, part, which was situated over the aortic arch was wrapped with omentum major near the anastomotic part.The advantages of this procedure were the prevention of the anastomotic leak,anastomotic stricture and reflux esophagitis.