食管与单层胃黏膜套入式吻合在贲门癌手术中的应用  

Application of a New Anastomosis - Esophageal Wall - Gastric Mucosa Invaginated Anastomosis in the Operation of Cardial Cancer

作　　者：肖建安[1] 李保中[1] 王海学[1] 魏林生[1] 

机构地区：[1]河南省安阳市肿瘤医院外一科,安阳455000

出　　处：《河南职工医学院学报》2003年第1期37-38,共2页Journal of Henan Medical College For Staff and Workers

摘　　要：目的探讨食管全层与单层胃黏膜套入式吻合法在预防贲门癌术后吻合口瘘、狭窄和返流中的效果。方法对156例贲门癌患者采用食管全层与胃黏膜单层套入式吻合进行消化道重建。结果术后无吻合口瘘,X线食管钡餐造影钡剂通过顺利,吻合口宽大,直径均在1.3 cm以上,头低脚高位(60°)无钡剂返流,术后6个月经食管镜检查,从吻合口以上被套入胃壁内3 cm长的食管腔呈关闭状,并可见突起延伸的黏膜皱襞、镜身均能顺利通过吻合口,术后随访1 a～3 a均无明显的胸骨后烧灼感、刺痛和咽下困难、进食呕吐等。结论贲门癌手术采用本吻合法层次清晰,缝合准确,抗张力强,吻合口径宽大、柔软,对预防吻合口瘘和狭窄有显著效果,同时具有一定的抗返流作用,能明显改善病人术后生存质量。Objective To explore the effect of a new method of esophagogastroanastomosis-esophageal wall-gastric mucosa invaginated anastomosis on preventing stomsl leakage, stenmosis and gastroesophageal reflux. Methods 156 cases of cardial - cancer patients were treated by operation. During the operation, esophageal wall - gastric mucosa invaginated anastomosis was performed to reconstruct the digestive tract. Results There was no anastomotic leakge after operaiton. Barium meal represented that the anastomotic stoma was wide enough with diameter more than 1.3 cm, the barium passed through the anastomotic stoma fluently and without reflux even in head - low feet - high position(60°) . 6 months after operation, esophagoscopic exam showed that the 3 cm-long esophageal lumen invaginated in gastric wall was closed and the protruding mucosal fold could be seen. The esophagoscope could pass through the anastomotic stoma without trouble. One to three years ' follow-up showed there was no apparent heart burn, postaternal stabbing pain, dysphagia or vomiting, etc. Conclusions It is a valuable means of anastomosis for proximal gastrectomy, which has the advantages of clear lamina, accurate suture, anti - tonic ability and wide, soft and functional anastomotic stoma, and has satisfactory effect on preventing anastomotic leakage, stenosis and reflux, thus improves greatly the survival quality of pyloric - cancer patients.

关 键 词：套入式吻合 吻合术 贲门癌 

分 类 号：R735.2[医药卫生—肿瘤] R730.56[医药卫生—临床医学]