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对 2 32例贲门癌患者采用食管全层与胃黏膜单层套入吻合进行消化道重建。术后无吻合口瘘 ,3个月内X线食管钡餐造影摄片 ,钡剂通过顺利 ,吻合口宽大 ,直径均在 1.3cm以上 ,头低脚高位 ( 6 0°)无钡剂返流 ,术后 6个月经纤维食管镜检查 ,从吻合口以上被套入胃壁内 3cm长的食管腔呈关闭状 ,并可见突起延伸的黏膜皱襞 ,镜身均能顺利通过吻合口 ,其中 14例食管有较轻微的黏膜充血、水肿 ,9例黏膜面有轻度凸凹不平变化 ,返流性食管炎发生率 9 9% ,术后随访 1～ 2年均无明显的胸骨后烧灼感、刺痛和咽下困难及进食呕吐等。初步临床实践体会 ,贲门癌行近端胃大部切除术时 ,采用本吻合法层次清晰 ,缝合准确 ,抗张力强 ,吻合口径宽大、柔软 ,对预防吻合口瘘和狭窄有显著效果 ,同时具有一定的抗返流作用 ,明显改善患者术后生存质量 ,是一种值得推荐的手术方法
2 32 cases of cardiac cancer patients with esophageal full-thickness and gastric mucosa monolayers into the anastomosis of the digestive tract reconstruction. No postoperative anastomotic fistula, 3 months of X-ray barium meal radiography, barium passed smoothly, anastomotic width, the diameter is above 1.3cm, high head low (6 0 °) without barium reflux, 6 months after operation by fiber esophagoscopy, from the anastomosis above the 3cm long esophageal cavity was closed into the stomach wall, and the protruding mucosal folds can be seen that the body can pass through the anastomosis, of which 14 cases of esophageal Mild mucosal hyperemia, edema, mild mucocutaneous mucosal changes in 9 cases, the incidence of reflux esophagitis 9 9%, 1 to 2 years after follow-up no significant retrosternal burning sensation, stinging and pharynx Difficulties and eating vomit. Preliminary clinical experience, cardia cancer near proximal gastrectomy, the use of the anastomosis of a clear level, accurate suture, strong tensile strength, wide anastomosis caliber, to prevent anastomotic fistula and stenosis have a significant effect, while having the A certain anti-reflux effect, significantly improve the quality of life of patients after surgery, is a recommended surgical method