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目的 扩展食管、贲门癌切除食管胃重建术的范围。方法 对胃溃疡胃大部分切除术后 9年又患胸中段食管鳞癌行根治性切除经食管床作横结肠胃食管颈部吻合术 1例 ;贲门癌侵犯食管下段行食管次全切除、全胃切除经食管床作横结肠空肠食管颈部吻合术 1例 ;另外 3例均因贲门癌行全胃切除 ,横结肠十二指肠食管弓下吻合术。本组 5例均切断中结肠动脉采用左结肠动脉升支供血的横结肠行顺蠕动向吻合。结果 其中 1例结肠胃食管颈部吻合术的病人 ,术后第 9日发现颈部吻合口瘘 ,术后第 2 3天痊愈出院。其余 4例病人均顺利出院。结论 横结肠有丰富的血供及足够的长度可移植至任何高度与食管吻合且愈合满意。
Objective To extend the scope of resection of esophagogastric resection for esophageal and cardiac cancers. Methods Gastro-esophageal esophageal squamous cell carcinoma with radical resection for transgastric esophagogastric esophagogastric anastomosis was performed in 1 case after partial gastrectomy for gastric ulcer in 9 years. Gastrointestinal cancer invaded esophageal subtotal resection and total gastrectomy in the lower esophagus. A transesophageal bed was used as a transverse colostomy esophagogastric neck anastomosis in 1 case; the other 3 cases were all undergoing total gastrectomy for gastric cardia cancer and transvaginal duodenal esophageal anastomosis. The 5 cases in this group were all cut off the middle colonic artery using the left colon to ascend the blood supply of the transverse colon line along the peristaltic dynamic anastomosis. Results Among the patients who underwent colonic gastroesophageal neck anastomosis, anastomotic fistula was found on the 9th postoperative day. The patient was cured and discharged on the 23rd postoperative day. The remaining 4 patients were discharged smoothly. Conclusion The transverse colon has abundant blood supply and sufficient length to be transplanted to any height and the esophagus is anastomosed and the healing is satisfactory.