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目的 探讨治疗贲门癌的手术新入路及吻合方法。方法 广东省揭阳市人民医院普通外科 1997年1月至 2 0 0 3年 7月经腹切开膈肌脚入路 ,行胃浆肌瓣覆盖 食管胃黏膜吻合 10 3例。结果 全组病例无死亡、无吻合口瘘 ,亦无食管切缘癌残留。术后并发症发生率 4 82 %。结论 经腹切开膈肌脚 ,行胃浆肌瓣覆盖 食管胃黏膜吻合术 ,操作在腹腔进行 ,创伤及生理干扰较小 ;能有效地预防吻合口漏 ;既能切除足够的食管 ,又能扩大淋巴结的清除范围 ,适用于浸润食管长度 <2cm的贲门癌的手术治疗。
Objective To explore a new surgical approach and anastomosis for cardia cancer. Methods General Surgery, Jieyang People’s Hospital of Guangdong Province From January 1997 to July 2003, the diaphragmatic muscle approach was performed by abdominal incision. 103 cases of gastric mucosal anastomosis were covered with gastric muscle flap. Results There was no death, no anastomotic fistula and no residual esophagectomy in all the patients. The incidence of postoperative complications was 4 82%. Conclusions Transverse incision of the diaphragm muscle foot, gastric pulp muscle flap covering esophageal and gastric mucosal anastomosis, the operation in the abdominal cavity, less trauma and physiological disturbance; can effectively prevent anastomotic leakage; can both remove enough esophagus, but also to expand Lymph node clearance range, suitable for infiltration esophageal cancer length <2cm surgical treatment.