Esophagogastric anastomosis ring cavity stretch

By | March 22, 2012

Esophagogastric anastomosis using intraluminal elastic loop elastic cutting principle, the esophagus and the stomach cavity with a rubber ring ligation in support tube on the wall so that the two are closely linked, cerclage at the parietal tissue necrosis, and gradually edge cutting edge suture, to the healing anastomosis. Necrotic tissue and the support tube 10-31 days off, the digestive tract discharge. Currently, the support tube can be absorbed has been put into clinical use, the support tube after 14-21 days to soften absorption, thus avoiding the support tube stuck in the digestive tract complications.
Esophagogastric anastomosis ring cavity stretch the advantage of leaving no foreign body anastomosis, but if the support tube near the location of the large blood vessels, supporting the formation of tubes may compress the artery wall necrosis, resulting in fatal bleeding, it is not appropriate for esophageal aortic arch an anastomosis.
Esophagogastric anastomosis ring cavity surgery stretch as follows.
conventional surgery free esophagus and stomach, esophageal anastomotic free to the location to be done at the top of 3cm. Cardia with a Kocher clamp after the clamp off.
esophageal anastomosis in the proposed use on the 10th lap to do purse silk suture around the esophagus, temporarily tie. 0.5cm in the purse line to do the esophageal anterior transverse incision one and a half weeks, with a large hemostat esophageal lumen by stretching the tube cut out, sewn with silk thread on the 4th through the gastric tube tip and tip holder support tube of small hole, 5cm apart after the two tied.
anesthetist from the nose to pull the tube, thereby pulling the support tube into the esophageal lumen, when the support tube into the esophagus just under the edge of the purse suture, the purse suture ligation. 0.5cm at its lower esophagus and the tumor resection.
the cardia of the Kocher clamp release, exhaust stomach contents. After the long forceps through the gastric cardia match department, caught the end of the lever, pull it from the cardiac incision. Fundus with oval clamp pliers, pushed along a fixed pole, so close to and surrounding the esophagus and gastric stump.
will have installed rubber ring set ring lever device penetration, and shun the lever will be pushed to the device set to ring at the esophageal stump, tighten the ring device is set to mark the end of the fixed-line knob, this time the bottom of the esophagus and stomach stomach tightly to the prison, the surgeon will set the handle closed loop control, the rubber ring placed in the middle sulcus support tube to complete the anastomosis.
release the knob set to ring out from the cardiac incision and fixed devices, gastric tube into the stomach cavity with the holder, cut the tip holder and the tube tip of the suture holes, the tube placed in the stomach, cardia residual suture end.
If the aortic arch anastomosis, be sure to support the pipe was located at the triangle at the bow, and set into the stoma stomach, package support tube, to avoid the oppression of the aortic arch. Xiachu fit in the bow, careful not to support tube compression descending aorta, the esophagus should be the relocation, with pedicled omental wrapping anastomosis.
support tube after the time off up to 31 days, the shortest 10 days, an average of 18 days.

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