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吻合方法的改进:1973年以前,我们对食管癌、贲门癌切除术,术中采用的吻合方法是:切除肿瘤后,先在胃上缝扎血管一圈,然后再造口与食管吻合。前后壁各二层缝合,前壁第二端为围领式包埋,一般包埋食管2～2.5cm。但术后吻合口瘘的发生率较高(14%)。1974年以来,我们除了采用保留胃及食管残端血运的措施外,对吻合口缝合方式进行了改进。即在胃、食管吻合,浆肌层包埋以及胸膜切缘与胃壁固定后,再将胃前壁悬吊于吻合口近侧及外侧壁层胸膜上,胃侧进针距吻合口1～1.5cm,深达肌
Improvement of the anastomosis method: Before 1973, we used the anastomosis method for esophageal and cardia cancer resection. After the tumor was removed, the blood vessel was sutured on the stomach for one circle, and then the stoma was connected with the esophagus. The two layers of the front and rear walls are sutured, and the second end of the front wall is encircled by a collar type, which usually encloses the esophagus 2 to 2.5 cm. However, the incidence of postoperative anastomotic leakage was high (14%). Since 1974, we have improved the method of suturing the anastomosis in addition to measures to preserve the blood supply to the stomach and esophageal stumps. After gastric and esophageal anastomosis, embolization of the seromuscular muscles, fixation of the pleural incisal margin and the gastric wall, the anterior wall of the stomach is suspended on the sternum on the proximal and lateral wall of the anastomotic stoma. The distance between the gastric side and the anastomotic stoma is 1 to 1.5. Cm, deep muscle