用食管导管施行食管胃、肠吻合术100例报道  

ESOPHAGOGASTROSTOMY OR ESOPHAGOENTEROSTOMY WITH A OPERATIVE ESOPHAGEAL CATHETER

作　　者：仇德惠[1] 郑如恒[1] 石美鑫[1] 蒋豪[1] 张燕影[1] 

机构地区：[1]上海医科大学中山医院胸外科,上海医科大学中山医院麻醉科

出　　处：《上海医科大学学报》1996年第2期114-116,共3页Journal of Fudan University(Medical Science)

摘　　要：为解决用吻合器或传统方法手工缝合施行食管胃或食管肠吻合术时，切开食管腔后食管内容物外溢污染术野，手工缝合时食管吻合部不能满意撑开、食管粘膜层显露欠佳，增加吻合术的难度，如吻合技术不妥易导致吻合口狭窄或吻合口瘘的不足。我们采用食管手术导管施行了１００例食管胃或食管肠吻合术，术中利用食管导管冲洗、支撑、扩张、阻断和吸引食管腔。手术操作便利，吻合满意，病人术后发热反应小，进食早，无吻合口瘘与吻合口狭窄发生。由于吻合前食管吻合部已被抗生素溶液冲洗；切去病变的食管或贲门后，食管手术导管能支撑着食管防止食管回缩，并能扩张开食管吻合部和吸去吻合时流入食管腔内的渗血，术野十分清楚；吻合时能清楚显露食管粘膜层和胃粘膜层的对合情况，不仅便于吻合术操作，而且可降低术后吻合口瘘，吻合口狭窄的发生率。PURPOSE Traditional esophagogastrostomy or esophagoenterostomy is performed by means of a esophageal clamp for anastomosis:when the esophageal cavity is opened,the contents in the esophageal cavity flow into the field of operation, the esophageal cavity can not be opened fully with the obscure exposure of mucosa,making the operation more difficult,and resulting in stenosis or fistula of anastomosis. Now esophagogastrostomy or esophagoenterostomy is performed with a operative esophageal catheter in order to overcome these defect.METHODS The esophageal area of anastomosis has been washed with antibiotic solution before anastomosis,and when the diseased section of the esophagus or cardia is removed,the operative esophageal catheter is used to sustain esophagus to prevent its retraction,dilate the area of anastomosis,and suck the ozzing blood shedding into the esophageal cavity during anastomosis.RESULTS There are no fistula,stenosis and thoracic suppuration in 100 cases of our group.The patients take in food carlier,and reaction of postoperative fever is less.The field of operation is quite clear,the connection of esophageal mucosa and gastric mucosa edges can be seen clearly.CONCLUSIONS All these give a great help in anastomosis and decrease the incidence of stenosis,fistula and thoracic suppuration.

关 键 词：食管胃吻合术 食管肠吻合术 食管手术导管 

分 类 号：R655.4[医药卫生—外科学] R656[医药卫生—临床医学]