Commonly used separation of esophageal and cardiac resection of esophageal a. separation range. Gradual separation of esophageal cancer from the bottom up to the top. The following esophageal cancer and cancer of all over the upper edge of at least 5cm long esophagus, should be isolated, removed. Left inferior ligament, hilar Department and esophageal tissue seen in the lymph nodes, need to be removed along with the esophagus.
b. separation of the tumor. Bronchial arteries from the descending aorta and the esophageal artery branch, to be in the two or both ends of the ligature clamp off between the eleven. Then continued separation of fibrous tissue surrounding the esophageal tumor, the tumor site completely free.
Commonly used separation of esophageal and cardiac surgery to avoid injury on the right pleural esophageal c.. Separation of the tumor, the right side of the pleura should be avoided injury. If accidentally torn right side of the pleura, it is timely suture. However, if the tumor has invaded the shallow and the right pleura or lung resection required, then do not have the right pleural suture, it may strengthen the respiratory control, and temporarily plug hole with gauze to prevent the inhalation of blood a lot of contralateral chest. Such as the right not cancer, but larger and difficult to suture the pleura break can also be temporary gauze packing, surgical gauze removed at the end of any of its open, so only the drainage of bilateral pleural drainage or left chest.
d. treatment of thoracic duct. Thoracic duct in the left posterior esophagus, aortic arch below the range between the descending aorta and azygos vein, such as adhesion and tumor should be resected with the esophagus, its coarse thread each end of the double ligation. Accidental injuries such as thoracic duct in the operation, but also need reliable ligation to prevent leakage of breast health and continued life-threatening.
Commonly used separation of esophageal and cardiac resection of esophageal aortic arch separating the rear e. esophagus. Separation, may be shrinking the lung, chest forward and down to reveal the top of traction. Gently pull down the lower esophagus, aortic arch can be seen in the upper part of esophageal left subclavian artery behind the extrapleural move. Along the left edge of the left subclavian artery directly to a bottom-up mediastinal pleura chest cut open the top. Followed by separation of the aortic arch with a finger above the esophagus, around the hose as the traction on the valuables. Above the aortic arch, thoracic duct into the side of the neck to move across the esophagus, separation should be taken to avoid injury. Then, with the right index finger down from the top of the aortic arch, the left index finger upward from below the aortic arch, the aortic arch gently to blunt dissection behind the esophagus. Behind the separation of the aortic arch must be close to the esophageal wall so as not to damage the thoracic duct is located deep and recurrent laryngeal nerve and so on. If the tumor is located in the rear of the aortic arch, isolation and difficulties, they can cut back outside the pleura aorta, ligation, cut off the 1-2 intercostal branch vessels, the aortic arch forward traction, the rear of the esophagus can reveal the bow for easy separation.