食管癌切除后,用胃代食管是常用的方法,一般是将胃自主动脉弓前方上提至胸腔做弓上或颈部吻合。这种方法术后在胸腔内形成一胸腔胃,有的病例胸腔几乎被膨大的胃所占据,使肺受压,减少了肺的有效呼吸面积,出现胸闷、气短、心慌等症状,进食后更为明显。为克服此缺点,乃将胃加以缝缩,形成一较细管状,但胃在胸腔内仍占有一定的位置,而且胃的缩小是暂时的,进食后仍然扩大使肺受压。同时上提之胃在主动脉的前方与食管吻合时,由于主动脉弓的突起而使吻合口亦形成一弯曲角度,不仅容易发生狭窄,而且常常增加吻合口的张力,造成吻合口漏,尤其在胸膜顶部吻合时较为困难。为此我们将 After removal of esophageal cancer, the use of gastro-esophageal replacement is a common method. Usually, the anomaly of the stomach is lifted from the front of the aorta to the thoracic cavity for an arch or neck anastomosis. After this method, a chest cavity stomach is formed in the chest cavity. In some cases, the chest cavity is almost occupied by the enlarged stomach, so that the lungs are compressed, the effective breathing area of ​​the lung is reduced, chest tightness, shortness of breath, palpitation, and other symptoms occur. Obviously. In order to overcome this shortcoming, the stomach is stitched to form a thin tube, but the stomach still occupies a certain position in the chest cavity, and the reduction of the stomach is temporary. After eating, it still expands to press the lungs. At the same time, when the stomach of the aorta is anastomosed to the esophagus in front of the aorta, the anastomotic arch also forms a bending angle due to the protrusion of the aortic arch, which is not only prone to stenosis, but also often increases the tension of the anastomotic stoma, causing anastomotic leakage, especially in the pleura. The top of the anastomosis is more difficult. For this we will