食管粘膜胃壁内潜入式食管胃腔内吻合实验研究

研究目的设计一种更为有效地防止吻合口瘘、吻合口狭窄和胃食管壁反流的手术方法。研究万法将健康杂种家犬30只随机分为实验组和对照组。实验组采用切除3cm肌层的食管粘膜经胃后壁潜道在胃腔内与胃粘膜吻合的方法。对照组采用传统吻合方法。不同时间分别处死相等犬数，进行大体标本及光镜比较观察和离休胃腔内注水观察反流情况。结果实验组无吻合口瘘发生，对照组发生2例。实验组吻合口平均宽26cm，对照组平均宽1.38cm（P＜0.05）。实验组抗反流效果明显出于对照组。结论本设计是一种理想的防止吻合口瘘、吻合口狭窄和胃食管反流发生的手术万法，极具临床推广实用价值。

Fxperimental study on esophagogastric intracavity anastomosis by esophageal mucosa sneaking into-form through gastric wall

Objective The aim is establishing a more effective operative mode for preventing anastomotic leak, stricture and gastroesophageal reflux.Methods Thirty healthy mongrel dogs were randomly divided into expremental and control group. In experimental group, pulling the mucosa resected esophageal seromuscular layer 3cm through the sneak path in gastric posterior wall, then the esophageal and gastric mucosa was anastomosed in gastric lumen. Tranditional anastomotic mode was performed in control group. The equivalent numbers of dogs were put to death respectively at different time to observe the reflux condition by pouring water into the resected gastric lumen and then to examine the gross and histological specimen.Results Postmortem examination reveals no anastomotic leak in experimental group and 2 cases of that in control group. The average width of anastomotic orifices is 2.6cm in experimental group and 1.38cm in control group (P<0.05).Antireflux effect of experimental group is obviously better than that of control group.Conclusion It is demonstrated that this operative model is an ideal method for preventing anastomotic leak, stenosis and gastroesophageal reflux, and possess certain practical value in clinical popularization.