全机械化吻合管状胃成形在食管癌切除术中的应用.docVIP

全机械化吻合管状胃成形在食管癌切除术中的应用 　　作者：杨丹宁,张光远,李鸿雁,何伟,胡定辉　　作者单位：江苏省中西医结合医院 心胸外科，江苏 南京 210028; 2.东南大学附属中大医院 心胸外科,江苏 南京 210009) 　　【摘要】 目的 探讨全机械化吻合管状胃成形在食管癌切除术中的应用及其优越性。方法 在57例食管癌患者手术中应用全机械化吻合管状胃成形，记录吻合时间与总手术时间，观察患者术后并发症发生情况以及术后住院时间等。结果 肿瘤均顺利切除，平均管状胃吻合成形时间28 min，平均总手术时间132 min;术后并发症少，无吻合口瘘或狭窄、吻合口溃疡、反流性食管炎及胸胃排空障碍发生;术后平均住院时间9.7 d。结论 该术式操作安全简单，重建消化道后更符合生理解剖的要求，减少了手术并发症的发生，利于患者消化系统功能恢复。 　　【关键词】 全机械化吻合;管状胃;食管癌 　　Application of tubiform stomach by complete mechanization inesophageal carcinosectomyYANG Danning1,ZHANG Guangyuan1,LI Hongyan1,HE Wei 2,HU Dinghui 1,LI Hang1(1.Department of Cardiothoracic Surgery,Jiangsu Hospital of Integrated Traditional Chinese and WesternMedicine,Nanjing 210028,China; 2.Department of Cardiothoracic Surgery,Zhongda Hospital,SoutheastUniversity,Nanjing 210009,China)　Abstract：Objective To investigate the application of tubiform stomach by complete mechanization in esophageal carcinosectomy and its superiority.Methods Tubiform stomach by complete mechanization was performed in 57 esophageal carcinoma patients.The inosculating time and the total operation time were recorded,the postoperative complications and length of stay after operation were observed.Results All of the tumor was exsected successfully,the average inosculating time was 28 min and average total operation time was 132 min.The postoperative complications was few and no anastomotic stoma fistula,anastomotic stoma narrow,stomal ulcer or chest gastric emptying block was occurred.The average length of stay after operation was 9.7 days.Conclusions This operation is simple and safe,the reconstituted alimentary canal is more physiologicoanatomical,this operation can reduce the postoperative complications,and accelerate the recovery of the patients. 　　Key words：complete mechanization;tubiform stomach;esophageal carcinoma 　　(Modern Medical Journal,2009,37:353355) 　　食管癌切除术中食管重建有多种方式，如结肠代食管、空肠代食管以及胃代食管，其中最常用的为胃代食管术，该术式涉及其他脏器少、创伤小，重建食管血供良好，取材方便，有足够的长度可供提升到任何高度进行吻合，手术操作简单;缺点是术后