Lower esophagus and cardia resection Note the smooth success of esophageal resection and surgical resection of the tumor to determine whether directly related. Mistakenly removed the tumor can be removed as not to give up surgery, or the removal of the tumor can not be regarded as surgery to remove the force, not only can not save the patient's life, but increased the burden on the patient.
Lower esophagus and cardia resection anastomosis above Note the free section of the esophagus not be too long, generally within 5cm, the muscle should be complete and not torn. Not damage the stomach, small and large curved vascular arcades, lack of blood supply in order to avoid anastomotic healing. Esophagus and stomach consistent with the best use of sets or embedded into the method, each suture needle when the inner layer should be the 'rope sewn on both sides of the mucosa, and with interrupted sutures, so as to avoid anastomotic stenosis. Layers of sutures must not be too dense, too tight, careful not to tear the esophagus, which are important preventive measures anastomotic thin.
Lower esophagus and cardia resection Note After separation of the esophagus, the mediastinal tissue should be cut ligation; pay attention not to damage the thoracic duct, such as the damage should be immediately ligation. Such as rupture of the contralateral mediastinal pleura, shall promptly repair; not fix, the customs should be placed opposite the chest closed thoracic drainage tube.
Lower esophagus and cardia resection Note sharp separation of the esophagus as far as possible operations, and make the necessary ligation of bleeding, the tumor will be removed along with surrounding lymph nodes. Finger blunt dissection is not only difficult to completely remove the tumor tissue, and easy to tear the tumor and surrounding organs.
Lower esophagus and cardia resection Note one in the lower esophageal aortic arch anastomosis is completed, the suture brain muscle should be careful not to narrow the chest mentioned in the stomach body; breast muscle and stomach wall between the needle can not be too sparse in the rib part of the brain should also be joint angle was tight, so as to avoid breast cancer.
Lower esophagus and cardia resection Note in the excision of the stomach and colon and esophageal can not use stump anastomosis, the jejunum can be used instead. Microsurgical operation, will do a free jejunal graft anastomosis to deal with esophageal defect, or transplantation of jejunum with vascular pedicle, and the upper mesenteric artery and vein anastomosis with the adjacent parts, to enhance its the end of the blood supply.