食管—胃浆肌层套式吻合在食管贲门癌根治术中的应用

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。

Application of shell-type anastomosis of esophago-gastric seromuscular layer in radical operation of cardiac cancer

Objective To evaluate the therapeutic effects of shell type anastomosis of esophago gastric seromuscular layer in radical operation of cardiac cancer. Methods Surgical treatment were performed in 387 patients. After closing the cardia or stump of stomach, a hole at fundus , top of the residual stomach or at the anterio wall was opened, then separated the exceeded mucosa of stomach. Using anaetomosis of esophageal whole layer with mucosal edge and fixed by separated serosa muscle layer. Results In 387 patients with this method, no anastomotic fistule and stricture happed. Conclusion The anastomosis can effective prevent the fistule and stricture of anastomotic stoma and the technical procedure is simpler.