【摘要】 目的 介绍“围巾式”食管.胃吻合方法预防食管下段及胃底切除术(Phemister术)后吻合口瘘和反流性食管炎的临床经验。方法 78例门静脉高压上消化道出血患者,均行Phemister术,采用“围巾式”食管-胃吻合消化道重建方式。结果 无手术死亡病例,1例术后发生残胃断口处吻合口瘘,其余77例均未发生吻合口瘘。无发生反流性食管炎病例。5例(5.1%)术后发生吻合口狭窄,经胃镜下球囊扩张后缓解,改进技术后再无吻合口狭窄发生。结论“围巾式”食管-胃吻合可减少Phemister术后吻合口瘘和反流性食管炎,是一种安全、有效的消化道重建方式。更多还原

【Abstract】 Objective To present the clinical experience of scarf-liking esophagogastric anastomosis in preventing anastomotic leak and reflux esophagitis in the lower esophageal and gastric fundus resection(Phemister operation).Methods The clinical data of 78 patients with portal hypertension and upper gastrointestinal bleeding who treated with Phemister operation and underwent scarf-liking esophagogastric anastomosis were analyzed retrospectively.Results Of all the 78 cases,1 case developed an anastomotic fistula of the gastric stump and none of the other 77 cases developed an anastomotic leak.None of the 78 cases developed reflux esophagitis.Anastomotic strictures occurred in 5 cases(5.1%) during the early stage,and they were relieved by gastroscopic balloon dilation.There was no more anastomotic stricture after the improvement of surgical techniques.Conclusion The new scarf-liking esophagogastric anastomosis has more advantages in reducing anastomotic leak and reflux esophagitis during the Phemister operation,which is a safe and effective method for digestive tract reconstruction.更多还原