经食管床全胃重建食管术的临床应用(附100例报告)

1985年9月至1991年1月间,我院应用经食管床全胃重建食管术治疗高位食管癌100例,获得较好的近期疗效。本术式的重点是经右胸游离并切除全胸段食管;行上腹正中切口经腹游离全胃,常规行幽门成形及沿小弯的管状胃缝缩术;将制备的管状全胃组织经食管裂孔,送于后纵隔食管床之中,再于左颈部将管状胃递出;最后于左颈部与食管(咽)行Gambee氏单层吻合术。本组胸内(心、肺)未发生术后并发症,颈部吻合瘘为2％。

Reconstruction of Esophagus with Whole Stomach through Esophageal Bed after Resection of Upper Esophagus Carcinoma.A Report of 100 Cases

From September 1985 to January 1991,100 reconstructions of esophagus with total stomach through esophagus bed after resection of upper esophagus carcinoma were performed with no operative mortality. The main steps of the proce- dure were(1) right thoracotomy for dissecting and removing the whole thoracic esophagus; (2) laparotomy for mobiliza- tion of the entire stomach and pyloroplasty, and (3) pulling the mobilized tubelike constricted stomach through the poste- rior mediastinal space (esophagus bed) out of the left neck incision and then the esophago-gastrostomy with Gambee's single layer anastomosis was performed. The leakage rate of cervical anastomosis Was 2%. No intrathoracic complication was found.