胃小弯延长新方法用于食管癌手术效果观察

目的探讨食管癌手术中胃小弯延长新方法的效果。方法常规的胃小弯延长法:对于胃常规处理之后其长度依然不符合条件的患者,将距离胃小弯处6～7cm的胃大弯实行V字形全层切开并拉直,使胃小弯延长并将切口缝合做成管型胃。改进的胃小弯延长法:手术过程中胃小弯侧沿和胃长轴的垂直方向取切口约5cm左右,作为浆肌层,切开后因为粘膜下层和肌层中间的结缔组织较疏松。粘膜可能顺着切口彭出,这时要仔细将粘膜下层作潜行分离使胃小弯松解,手术过程中要密切注意粘膜下层的血管网,要尽量避免血管和胃粘膜损伤,使胃粘膜与膜下血管网保持的较完整。要充分将小出血点止血,最后将浆肌层纵向间断缝合1层即可,延长胃小弯。结果常规法与改进法对比后,可见术后的并发症发生率出现明显不同,改进后的方法并发症发病率明显低于常规法。结论改进后的胃小弯延长法并发症概率显著降低,可在临床广泛推广。

Extend the Lesser Curvature of the Stomach for Esophageal Cancer Effects Observed

Objective To observe the effect of esophageal cancer surgery lesser curvature of the stomach to extend the new ap- proach. Methods The regular lesser curvature Extension Act： its length after conventional treatment for stomach still does not meet the conditions of the patients, the implementation of the V-shaped full-thickness incision and straighten 6-7 cm from the lesser curvature of the stomach, gastric antrum, extend the lesser curvature and the incision is made of tube-type stomach. Improved lesser curvature Extension Act： the lesser curvature along the vertical direction of the long axis of the stomach during the proce- dure to take incision about 5 cm, as the urothelium since the middle of the connective tissue of the submucosa and muscularis cut loose. Mucosa may be out along the incision Peng carefully the submucosa separation sneak the lesser curvature of the stomach re- lease, surgical procedures, pay close attention to the vascular network of the submucosa, to minimize the risk of vascular and gas- tric mucosal injury, the gastric mucosa and film vascular network to maintain a more complete. The full small bleeding points to stop bleeding, and finally the urothelium longitudinal interrupted suture layer can extend the lesser curvature of the stomach. Re- suits Conventional method and Improvement Act of contrast, the visible postoperative complication rate was significantly different, the improved method of the incidence of complications was significantly lower than the conventional method. Conclusion Improved the lesser curvature of the stomach extend the method complication probability significantly reduced in clinical widely.