肋间肌原位移植代食管手术,是为简化食管癌手术操作,消除胃或结肠代食管手术的并发症和后遗症而设计。将与食管病变位置相应的肋骨分离,切下肋骨上下的肋间肌,缝成肌管,内置硅胶管支撑,肌管与切除病变食管上下端吻合。肌管由肋间动脉供应血运。经28只动物实验,肌管与食管愈合良好。术后不同时间尸检肌管,术后三个月肌管柔软,二年后肌管内面全由食管粘膜上皮覆盖。本手术1981年应用于临床,已作三例病人均获成功。这种手术方法操作简单,创伤小失血少,1小时45分钟即可完成手术。肌管移植在食管床内,术后肺膨胀好,病人呼吸、血压、脉搏平稳,进食顺利。文中详述手术方法和第一例病人术后处理经过。 Intercostal muscle orthotopic transplantation for esophageal surgery is designed to simplify the surgical operation of esophageal cancer and eliminate the complications and sequelae of gastric or colonic esophageal surgery. The ribs corresponding to the esophageal lesions were separated, the intercostal muscles were cut off from the ribs, and sutured into myotubes. The stents were embedded with silicone tubes. The myotubes were ligated with the lesions on the upper and lower ends of the esophagus. Myotubes are supplied by the intercostal artery. After 28 animals were tested, myotubes and esophagus healed well. The myotubes were autopsied at different times after surgery and the myotubes were soft for three months after surgery. The inner surface of the myotubes was covered by esophageal mucosal epithelium two years later. This surgery was applied in clinical practice in 1981 and has been successfully performed in three patients. This surgical method is simple, less traumatic and less blood loss, and surgery can be completed in 1 hour and 45 minutes. The myotube graft was in the esophagus bed. After the operation, the lungs swelled well. The patient’s breathing, blood pressure, and pulse were stable, and the feeding was smooth. This article details surgical procedures and the first postoperative patient treatment.