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目的 观察食管—胃浆肌层套式吻合在食管癌、贲门癌根治术的治疗效果。方法 手术治疗387例。关闭贲门或胃残端后 ,于残胃“底”的顶部或前壁切开与食管腔相适应的开孔 ,将胃的浆膜肌层与粘膜层分离 3cm ,切除多余的胃粘膜 ,将食管全层与胃吻合口之粘膜缘用 3— 0肠线连续缝合 ,然后将胃吻合口已分离的浆膜肌层上提包套食管吻合端 ,固定 6～ 8针。结果 387例食管—胃浆膜肌层套式吻合中无吻合口反流 ,无吻合口狭窄和瘘发生。结论 食管癌贲门癌切除食管—胃浆膜肌层套式吻合能有效预防吻合口反流、吻合口狭窄和吻合口瘘 ,技术操作较简单。
Objective To observe the therapeutic effect of esophageal-gastric musculoskeletal sleeve anastomosis in esophageal and cardiac cancer radical surgery. Methods Surgical treatment of 387 cases. After closing the cardia or gastric stump, open the opening corresponding to the esophagus cavity at the top or anterior wall of the stomach “bottom,” separate the stomach’s serosal muscularis and the mucous membrane 3 cm, and remove the excess gastric mucosa. The mucosal margins of the esophagus and gastric anastomosis were sutured consecutively with 3-0 guts, and then the seromuscular muscles on which the gastric anastomosis had been separated were placed on the esophageal anastomosis end and 6-8 needles were fixed. Results There was no anastomotic reflux in the 387 esophageal-gastric serosal muscular anastomosis, and no anastomotic stricture or fistula occurred. Conclusion Esophageal-stomach sarcomerial sleeve anastomosis for resecting esophageal and cardiac cancer can effectively prevent anastomotic reflux, anastomotic stricture and anastomotic leakage, and the technical operation is simple.