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[目的]评价全胸腹腔镜下Ivor Lewis食管癌切除术中直线吻合器吻合应用的价值。[方法 ]整个吻合过程借助腔镜下直线切割吻合器(强生Ethicon flex 60直线吻合器)完成。首先,以直线切割吻合器斜向上方击发建立胃食管的侧—侧吻合形成吻合口的上、下两壁,再次使用直线切割吻合器沿管状胃的延长线切割击发,完成吻合口的制作,同时切除胃小弯及食管肿瘤。当吻合完成后吻合口的平面呈矢状位,由上缘、下缘和前缘构成。[结果]2014年2月至2015年12月,共有28例患者接受这种吻合方式的Ivor Lewis食管癌切除术,最长随诊时间为22个月,最短1个月,无吻合口出血,无吻合口瘘及吻合口狭窄。[结论]T形吻合应用于全胸腹腔镜Ivor Lewis食管癌切除术受空间制约小、操作过程简单、吻合可靠,是一种安全有效的全胸腔镜下胸腔内胃食管吻合方式。
[Objective] To evaluate the value of linear stapler anastomosis in total thoracoscopic laparoscopic Ivor Lewis esophagectomy. [Methods] The whole anastomosis process was completed with a linear endoscopic stapling device (Johnson flex 60 linear stapler). Firstly, the upper and lower walls of the anastomotic stoma were established by linearly cutting the stapler obliquely upwards and the side-side anastomosis of the gastroesophageal anastomosis was established. The straight-line cutting and stapling device was used to cut along the extension line of the tubular stomach to complete the anastomosis. At the same time, the small curvature of the stomach and esophageal cancer were removed When the anastomosis is completed, the plane of the anastomosis is sagittal and consists of an upper edge, a lower edge, and a leading edge. [Results] From February 2014 to December 2015, a total of 28 patients received this anastomosis Ivor Lewis esophagectomy, the longest follow-up time was 22 months, the shortest one month, no anastomotic bleeding, No anastomotic fistula and anastomotic stenosis. [Conclusion] The T-shaped anastomosis is a safe and effective intrathoracic intragastric gastroesophageal anastomosis in total thoracic surgery for Ivor Lewis esophageal cancer resection with small space restriction, simple operation and reliable anastomosis.