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1993年2月～1999年10月,笔者行左侧剖胸中下段食管癌或贲门癌切除、带蒂大网膜包裹及带蒂纵隔胸膜瓣包盖食管-胃吻合口手术304例,无1例发生吻合口瘘。现报告如下: 1 资料与方法 1.1 一般资料 本组304例中,男性229例,女性75例;年龄31岁～77岁,平均59.6岁;中下段食管癌210例,贲门癌94例。 1.2 手术方法 (1)中下段食管癌:一律行左胸后外侧切口经第6肋间进胸,有时需同时剪断第6后肋;贲门癌行左胸后外侧切口经第7肋间进胸。(2)游离胃时,有意保留胃大弯近端4cm×4cm范围的大网膜,并将其裁剪成“Y”型;多余的大网膜予以部分切除,勿损伤血管弓;将食管吻合缘上方食管前壁表面的纵隔胸膜,自
From February 1993 to October 1999, the author performed 304 cases of esophageal-gastric anastomosis surgery in which 304 patients underwent esophageal or cardiac cancer resection, pedicled omentum-wrapped and pedicled mediastinal pleural flaps on the left side of the thoracoabdominal thoracotomy, and there was no case. Anastomotic leakage occurred. The report is as follows: 1 Materials and Methods 1.1 General Information In this group of 304 cases, 229 males and 75 females; aged 31 to 77 years, mean 59.6 years; 210 cases of middle and lower esophageal cancer, 94 cases of cardiac cancer. 1.2 surgical methods (1) in the lower esophageal cancer: the left chest after the incision through the 6th intercostal chest into the chest, and sometimes need to cut the 6th post rib; cardia cancer left chest posterior lateral incision into the chest through the 7th intercostal . (2) When the stomach is free, it is intended to retain the omentum 4cm x 4cm proximal to the large curvature of the stomach, and cut it into a “Y” shape; the excess omentum is partially removed and the vascular arch is not damaged; the esophageal anastomosis Mediastinal pleura on the surface of the anterior esophageal wall above the margin, from