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我院自 1996年 7月至 1999年 6月 ,开展食管贲门癌切除 ,胃与食管吻合方法改进手术 5 0例。吻合方法胃后壁浆肌层与食管肌层间断缝合 3针 ,而后胃后壁与食管后壁及胃前壁与食管前壁全层 ,用 3～ 0无创可吸收合成线连续缝合 ,胃前壁浆肌层与食管前壁间断缝合 3针。手术结果治疗组无吻合口瘘及吻合口狭窄 ,术后 2～ 3周出院 ,随访 2个月至 3年 ,未发现吻合口狭窄。对照组 2 0例 ,用常规吻合方法 ,术后发生吻合口瘘 2例 ,吻合口狭窄 1例。讨论该手术方法的改进 ,胃与食管连续缝合方法的优点 ,预防吻合口瘘。结论 用 3～ 0无创伤可吸收合成缝合线 ,行食管胃连续缝合的方法是目前食管胃吻合较理想的吻合术式 ,值得临床推广使用。
In our hospital from July 1996 to June 1999, we performed esophageal and cardiac cancer resection and improved gastric and esophageal anastomosis in 50 cases. Anastomotic approach Three layers of sutured sutured posterior gastric mucosa and esophageal muscular layer, and posterior gastric wall and esophageal posterior wall and anterior gastric wall and esophageal anterior wall were sutured consecutively with 3 to 0 noninvasive absorbable synthetic threads. Muscular sarcoplasmic wall and the anterior wall of the esophagus were sutured with 3 needles. The surgical result showed no anastomotic leakage and anastomotic stenosis. The patients were discharged 2 to 3 weeks after operation and followed up for 2 months to 3 years. No anastomotic stenosis was found. In the control group (20 cases), with conventional anastomosis, there were 2 cases of anastomotic fistula and 1 case of anastomotic stenosis. Discussion of the improvement of the surgical method, the advantages of continuous suture of the stomach and esophagus, prevention of anastomotic leakage. Conclusions The use of 3 to 0 non-invasive synthetic sutures for continuous esophagogastrostomy is currently an ideal method for anastomosis of esophagogastric anastomosis and is worthy of clinical application.