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食管癌切除,颈部食管、胃吻合过去采用直接在颈部解剖、游离食管、拉胃和食管包套的方法进行吻合。喉返神经损伤、吻合口瘘、吻合口狭窄的发生率高。作者用改进的方法对99例食管癌作了食管胃吻合。在胸锁乳突肌内缘切开皮肤、皮下组织后,颈前肌群在术者从胸内伸至颈部的手指的引导下切开,这样就避开了喉返神经。然后提拉胃粘膜下血管的缝扎线,胃可轻易提至颈部,胃的血运好。加之食管、胃前壁是单层吻合,所以术后并发症的发生率明显减少。改进的手术方法简单安全,易掌握,具有一定的实用价值。
Resection of esophageal cancer, cervical esophageal, gastric anastomosis in the past using anatomy in the neck, free esophageal, gastric and esophageal capsule method of anastomosis. The incidence of recurrent laryngeal nerve injury, anastomotic leakage, and anastomotic stricture was high. The authors used an improved method to perform esophageal and gastric anastomosis in 99 cases of esophageal cancer. After incision of the skin and subcutaneous tissue in the sternocleidomastoid muscle, the anterior cervical muscles were incised under the guidance of the surgeon’s fingers extending from the chest to the neck, thus avoiding the recurrent laryngeal nerve. Then the sutures of the gastric submucosal vessels are pulled up, the stomach can be easily lifted to the neck, and the blood supply of the stomach is good. In addition, the esophagus and the anterior wall of the stomach are single-layered anastomosis, so the incidence of postoperative complications is significantly reduced. The improved surgical method is simple, safe, easy to grasp and has a certain practical value.