食管-胃浆膜肌层套式吻合术的实验研究和临床应用

为预防吻合口远期狭窄,作者设计了食管-胃浆膜肌层套式吻合术。管腔内前后壁用3-0肠线连续缝合。通过实验与“套叠式”吻合术对比观察,发现肠线吸收快、反应轻,吻合口不易狭窄;吻合口丝线残留、纤维组织增生和瘢痕形成为导致远期狭窄的主要原因。临床应用180例,同样取得良好结果。术后无吻合口瘘、狭窄及反流发生,其操作技术不难,安全可靠,易于掌握。

An Experimental Study of a New Sleeve Esophagogastrostomy and Its Clinical Application

The results of our experimental study revealed that the redidual silk sutures and their influence are often a major factor contributing to anasto-motic stricture in later period after esophagogastrostomy. Base upon this finding a new sleeve esophagogastrostomy was designed by authors which proved highly effective in preventing anastomotic stricture in an animal study. This technique required that the esophageal stump be sutured continuously with 3-0 chronic catgut to the gastric mucosa which was cut short by 3 cm compared with the layer consisting of serosa and musculature, and the latter was repaired at the site of anastomosis for reinforcement. It was employed in 180, and the good results obtained thereby demonstrated that it was effective in the prevention of anastomotic leakage, stricture and reflux esophagitic. Above all, this technique has the advantages of being simple, safe and easier to manipulate.