CAJ | 학술논문

目的：分析观察食管癌手术中使用食管胃高位胸顶吻合加纵膈胸膜减张覆盖的手术方式完全杜绝手术之后出现口瘘的情况。方法随机选取我院50例食管癌病患，全部进行左侧开胸，食管胃吻合使用统一标准的吻合方式，也就是吻合位在高位胸顶处。吻合口全部为机械吻合，然后使用无损伤线不连续的进行强化缝合一周；两边的胃壁悬挂在胸膜减张。吻合口前端部位胸膜覆盖再次执行减张。结果全部入选病患没有一例发生口瘘情况，全部痊愈出院。结论食管胃高位胸顶吻合加纵隔膜减张覆盖的方式，在食管癌手术过程中对吻合口存在多方面的保护操作，能够明显防止口瘘出现，而且操作方法效率高易操作，便于临床推广。
목적：분석관찰식관암수술중사용식관위고위흉정문합가종격흉막감장복개적수술방식완전두절수술지후출현구루적정황。방법수궤선취아원50례식관암병환，전부진행좌측개흉，식관위문합사용통일표준적문합방식，야취시문합위재고위흉정처。문합구전부위궤계문합，연후사용무손상선불련속적진행강화봉합일주；량변적위벽현괘재흉막감장。문합구전단부위흉막복개재차집행감장。결과전부입선병환몰유일례발생구루정황，전부전유출원。결론식관위고위흉정문합가종격막감장복개적방식，재식관암수술과정중대문합구존재다방면적보호조작，능구명현방지구루출현，이차조작방법효솔고역조작，편우림상추엄。
Objective To observe the operation of esophageal cancer with esophageal and gastric high thoracic apex anastomosis with mediastinal pleural cuts a cov-ered way to completely eliminate the operation after operation occurred fistula .Methods Randomly selected in our hospital 50 cases of esophageal cancer patients,all were left thoracotomy,esophagogastrostomy anastomotic mode use standard,which is consistent in the high thoracic top.Anastomotic all mechanical anastomosis,and then use the non wound line is not continuous strengthening suture a week;on both sides of the wall hanging in the pleural tension .The front end cover mouth with pleura reduces tension again.Results All the patients had no cases of anastomotic fistula,all recovered and discharged.Conclusion Gastro esophageal anastomosis with high chest top longitudinal diaphragm tension over the existing protection operation,many aspects of the anastomosis in esophageal cancer operation process,can effectively prevent the fistula occurred,and the operation method of high efficiency and easy to operate,convenient clinical.