食管胃黏膜活瓣式吻合术在食管下段癌、贲门癌切除中的应用

目的 探讨食管下段癌、贲门癌切除后食管胃黏膜活瓣式吻合术的方法及临床体会.方法 肿瘤切除及淋巴结清扫后消化道重建时,剥除食管肌层及胃浆肌层,使黏膜延长3～4 cm,然后食管黏膜与胃黏膜分层吻合,浆肌层包埋,包埋后吻合口置入胃腔内2-3 cm,切除胃超过2/3以上时辅以大网膜包绕吻合口.结果 施行该吻合方法38例,均恢复顺利,近期并发症3例,其中心律失常1例,肺部感染1例,乳糜胸1例,均经保守治疗全部治愈,随访半年后均可顺利进普通饮食,无吻合口狭窄及反流性食管炎表现.结论 食管胃黏膜活瓣式吻合术可有效地预防吻合口漏、狭窄、反流等并发症.

Application of valverform esophagogastrostomy after excision of lower esophageal and gastric cardia cancers

Objective To evaluate the application and experience of valverform esophagogastrostomy af-ter excision of lower esophageal and gastric eardia cancers. Methods When reconstructing digestive tract after tumor resection and lymph node dissection, the esophageal and gastric lamina mnscularis was stripped,making mueose membrane extend 3-4 cm, and esophageal mueosa and gastric mucosa were anastomosed.Then lamina muscularis was embedded ,and anastomotic stomas were inserted into the stomach 2-3 cm. When gastric resection was more than 2/3 anastomotie stoma was encased by omentum majus. Results Among the 38 cases undergone esophagogastrostomy complications occurred in 3 cases, of which 1 case with cardia ar-rhythmias, 1 lung infection, 1 chylothorax, all cured by conservative treatment. No anastomaotic stenosis and reflax esophagitis occurred during six -month follow up. Conclusion Valverform esophagogastrostomy can effectively prevent anastomotic leakage, stenosis, reflux and other complications.