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目的 :避免食管贲门癌术后发生幽门梗阻。方法 :对胃的游离范围进行了改进 ,常规游离胃超过幽门 2cm～ 3cm达十二指肠球部。结果 :幽门梗阻的发生率 :改进前 6/342 ,其中 :食管癌 1 /1 0 4占 0 .96% ,贲门癌 5/2 38占 2 .1 % ;改进后 0 /2 2 6。结论 :切断食管时把支配胃的副交感神经纤维随同迷走神经全部切断 ,胃的交感神经仍存在。为了避免副交感神经切断后 ,交感神经功能相对亢进发生幽门痉挛导致非机械性幽门梗阻。应常规游离胃超出幽门 2cm～ 3cm达十二指肠球部 ,使支配胃的交感神经也被切断 ,防止胃的神经调节功能紊乱。
Objective: To prevent postoperative pyloric obstruction of esophageal and cardiac cancer. Methods: The free range of the stomach was improved, the conventional free stomach over the pylorus 2cm ~ 3cm up to the duodenal bulb. Results: The incidence of pyloric obstruction: 6/342 before improvement, of which: esophageal cancer 1/104 accounted for 0.96%, cardia cancer 5/2 38 accounted for 2.1%; improved 0/226. Conclusion: When the esophagus is cut off, the parasympathetic nerve fibers that dominate the stomach are cut off along with the vagus nerve. The sympathetic nerves still exist in the stomach. In order to avoid parasympathetic seizures, the relatively sympathetic function of pyloric spasm resulting in non-mechanical pyloric obstruction. Stomach should be routinely out of the pylorus 2cm ~ 3cm up to the duodenal bulb, so that the sympathetic innervation of the stomach is also cut off to prevent gastric neuromodulation disorders.