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本文报道食管和贲门癌切除手术325例,癌肿大多为晚期,吻合口瘘占1.2%,手术死亡率1.8%,作者的经验是:不同部位及不同程度的食管和贲门癌采用不同的切口及不同的手术方法;胃左动脉在其根部结扎切断;吻合口采用端侧缝合;吻合口作在胃残端闭合缘的下方1cm 处;吻合口的横径与胃残端闭合缘相平行;对营养差的病人术中置放十二指肠滴管,术后滴入营养液;积极处理术后胸内残腔;手术结束时用0.3%卡那霉素溶液冲洗胸腔。
This article reported 325 cases of esophageal and cardia cancer resections. Most of the cancers were advanced. Anastomotic fistulas accounted for 1.2%. The operative mortality was 1.8%. The author’s experience is that different sites and different degrees of esophageal and cardiac cancer use different incisions and Different surgical methods; left gastric artery ligation at its root; anastomosis using end suture; anastomosis at 1cm below the closed edge of gastric stump; the diameter of the anastomosis parallel to the closed edge of gastric stump; Patients with poor nutrition placed intraoperative duodenal dropper during operation and drip in nutrient fluid after surgery. After active treatment of residual cavity in the chest, the chest cavity was washed with 0.3% kanamycin solution at the end of the operation.