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目的 减少食管癌颈部吻合术后吻合口相关并发症的发生率。方法 将王国清等[1] 舌状浆肌瓣覆盖食管胃粘膜吻合术应用于颈部食管胃吻合。后壁为食管全层对胃全层吻合 ,前壁为食管全层与胃粘膜吻合。结果 全组术后无吻合口瘘发生。术后X线检查见钡剂通过顺利 ,吻合口呈直线状。其中 5 4例术后 3～ 6个月行食管镜检查 ,见吻合口光滑直径 1.0～ 2 .0cm ,吻合口上方食管粘膜正常 ,未见返流性食管炎征象。结论 该方法操作简单 ,对减少术后颈部吻合口瘘 ,防止狭窄有较明显的作用。吻合口前壁突入胃腔类似瓣膜结构 ,有较好的抗返流作用。
Objective To reduce the incidence of anastomotic complications after neck anastomosis of esophageal cancer. Methods Wang Guoqing et al. [1] lingual musculoskeletal flap overlying esophagogastric mucosal anastomosis was applied to cervical esophagogastric anastomosis. The full esophagus of the posterior wall was anastomosed to the entire layer of the stomach, and the anterior wall was full of esophageal anastomosis with the gastric mucosa. Results No anastomotic fistula occurred after operation in the whole group. Postoperative X-ray examination showed that the sputum passed smoothly and the anastomosis was linear. Fifty-four patients underwent esophagoscopy 3 to 6 months after surgery. The smooth diameter of the anastomosis was 1.0-2. 0cm. The esophageal mucosa above the anastomosis was normal. There was no sign of reflux esophagitis. Conclusions This method is simple and effective in reducing postoperative neck anastomotic leakage and preventing stenosis. The anterior wall of the anastomosis protrudes into the gastric cavity resembling a valve structure and has a good anti-reflux effect.