Lower esophageal thoracic aortic arch – anastomosis – exploration

By | March 21, 2012

Lower esophageal thoracic aortic arch – anastomosis – exploration, first in the xiphoid and umbilical incision between the rectus abdominis left to do (can do abdominal incision near the middle of the middle or the left) into the abdominal cavity exploration.
General will check the left and right hepatic lobe and hepatic portal metastasis; Secondly, the observation of large and small retinal and gastrointestinal surface, and then check both sides of the abdominal aorta and pelvic palpation reach people without nodules; Then, check tumor size, scope and activity, and to the serosal surface of the gastric fundus and lesser curvature with or without proliferation, and to check the brain and the muscle under the splenic metastasis and enlarged lymph nodes. Lower esophageal thoracic aortic arch – anastomosis – exploration, and finally, check the gastric ligament of liver, stomach and duodenum around the roots of the left artery metastasis, and in the stomach at the greater curvature of the greater omentum cut into small abdominal cavity, filed stomach, pancreas along the upper edge of the stomach wall to the left gastric artery palpable roots exploration with or without swelling, fixed lymph nodes, whether the violation of pancreas and abdominal aorta and so on.
Lower esophageal thoracic aortic arch – anastomosis – exploration, according to probe the situation, make the following judgments:
tumor than its predecessor, is not clear violation of adjacent organs or local lymph nodes only a few can be completely removed, should be radical resection;
the tumor has involved the lesser curvature of the stomach and the fundus, or part of the intrusion or in the vicinity of the retinal membrane gland, lymph node was swollen, little hope of radical surgery, but if the patient permits, palliative resection can be conducted in order to reduce symptoms;
intrahepatic metastatic nodules, extensive peritoneal metastasis, tumor fixed in the abdominal wall, or abdominal artery extensive lymph node swelling around the tumor is not eradicated, but if circumstances permit, may also consider making greater curvature of the esophagus and stomach bypass anastomosis.

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