经隧道食管胃腔内吻合术的临床观察

研究目的设计一种简便有效的食管—胃吻合方法，减少和防止吻合口瘘，避免吻合口狭窄和胄食管反流等并发疾的发生。研究背景食管癌、贲门癌术后吻合口瘘的发生率在2．6％～7％，病死率高达30％～50％。手术方法不当是其发生的主要原因，但至今尚无一种较为理想的术式，因此我们进行了本研究。方法　临床观察及术后两周X钱钡剂上消化道造影，观察吻合口宽度．头低足高位观察胃食管反流情况。食管内置管测定pH值。结果本组223例中无吻合口瘘发生。术后两周行上消化道造影，吻合口轻度狭窄（0.6cm～0.8cm）2例，有反流者2例。结论本术式简便可靠，能有效地防止吻合口瘘，预防吻合口狭窄和胃食管反流。

Clilical observations on esophagogastric stomy through "tunnel" in gastric lumen

Objective To design a simple and effective type of esophagogastric stomy for reduce and prevent from the complications leak and stenosis of apastomotic orifice, and gastroesophgeal reflux.Background The incidencs of anastomotic leak were 2.6%~7% and the fatality rates were 30%~50%, because of a satisfactory operative fashion in traditional methods was lack.Methods The anastomotic oriflce width and the reflux which was tested in a posture of head low and feet high were observed clinically and examined by radiographically affer operation two weeks pH value was also meaured by putting a pH monitoring duct in esophgus Result There were no postoperative anastomotic leakage in all cases by the operative method. There are 2 cases with slight anastomotic stricture (0.6~0.8cm) and 2 cases with gastroesophogeal reflux in the findings of X-rag examination.Conclusions The results show that this operathve method is simple and reliable, and could prevent from anastomotic leakage, stenosis and gastroesophageal reflux.