Colon, small intestine reconstruction of the esophagus method

By | March 22, 2012

(1) colon, small intestine reconstruction of esophagus esophageal reconstruction method of colon surgery. First by Kelling and Vulliet used in 1911 until after the treatment of benign esophageal stricture is widely used in clinical. Esophageal reconstruction has the advantage of the colon: a sufficient length instead of the whole esophagus; colon environment, pH, about 6.5, acidic, so more acid and will not reflux esophagitis and stricture formation; the same time retain the original anatomy of the stomach and physiological function, less post-operative gastrointestinal dysfunction. But the complexity of surgical procedures, there are three anastomosis, trauma increases the incidence of postoperative complications may be increased. If the formation of thin or colon anastomotic necrosis and mortality. Colon, small intestine reconstruction of the esophagus law the following:
esophageal replacement with colon surgery indications. For cervical, upper thoracic esophageal cancer patients, especially in the past done gastrectomy surgery; carcinoma invading the esophagus, throat and need to do all those radical resection of cervical esophagus; on behalf of the esophagus with stomach surgery failed to be re- repair cases; esophageal resection, on behalf of the esophagus to the stomach difficulties; advanced esophageal cancer patients, or poor general condition who can not tolerate thoracotomy, or thoracotomy, the tumor is not resected.
colon a contraindication to esophageal surgery. There dehydration and anemia, hypoproteinemia patients, systemic atherosclerosis, ulcerative colitis, and other organic colonic disease patients that the method is disabled.
vascular graft intestines and nutrition choices. What section of colon with which the esophagus, consistent view of each, depending on the habits and surgery branch of the nutrient artery anatomy and blood supply are familiar with the situation. Most domestic scholars have used the left colic artery and the transverse colon on behalf of the esophagus, on the grounds that: a. the transverse colon is located in the upper abdomen, the abdominal incision to facilitate free; b. transverse mesocolon long edge of the vascular arcades are often well-developed; c. use of transverse colon The full-length, no free or descending colon, ascending colon, cervical anastomosis can be achieved, if the length is not enough, either left or right colon are easily extended; d. left colonic artery is the first one inferior mesenteric artery branch, multi-system Crude large, good blood circulation.
a colon transplant colon and esophageal anastomotic location. Transplantation within the colon in the chest, do chest or neck anastomosis in colon anastomosis. The advantages of a shorter length of colon required, the colon is relatively easy to ensure that the blood supply; The disadvantage is that in the event of anastomotic colonic necrosis or thin, high mortality. Transplantation in the chest outside the colon, cervical esophageal do. Common procedure is to set teeth retrosternal colon. The advantages: thin or in case of anastomotic colon necrosis, and more non-life-threatening.
esophageal replacement with colon common surgical method. Common surgical methods include three kinds: a. a ventral cervical approach of a thoracic tumor resection, esophageal surgery of substernal colon; b. an abdominal incision the left breast, tumor resection, esophageal surgery intrathoracic colon; c. Non-opened Chest turned pull out the esophagus, esophageal bed esophagus colon surgery.
(2) colon, small intestine jejunum reconstruction of esophageal reconstruction in esophageal method. Reconstruction of the esophagus and the jejunum is Raux Herzam successfully used in the 1907's. Jejunum with vascular arch, vascular rich, you can replace the entire esophagus on the neck that can also replace the stomach. As a short jejunal vascular arcades, anatomical variations and more jejunal mucosa is not acid, it is rarely used in conventional esophageal reconstruction after resection of the esophagus, and the main total gastrectomy for cardiac cancer of the esophagus stomach and jejunum on behalf of the surgical procedures. In recent years, scholars in the cervical esophageal resection with vascular pedicled free jejunum reconstruction of cervical esophagus. Vascular anastomosis in the microscope in the thyroid vein or external jugular vein, and the collar artery, superficial cervical vein. Intrathoracic anastomosis can be used in the internal thoracic artery and vein and the azygos vein.

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