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反流性食管炎是食管贲门癌切除、食管胃吻合术后的一种常见并发症。其原因是贲门区结构被切除,破坏了食管胃的抗反流生理功能。近年来,很多著名的胸外科医生设计了许多种抗反流的手术方法,如幽门成形术,套入式食管胃吻合术、胃后壁胃底折叠吻合术、胃底折叠瓣膜成形术、吻合口肋间肌束悬吊术等等,但效果均不理想,且延长了手术时间或增加了手术难度。我院于1980年5月至1982年5月,根据食管胃抗反流的解剖生理机制,采用一种重建食管胃抗反流功能的术式,即用胃小弯食管包埋式食管胃吻合再加胃底成形术,共施行20例,抗反流效果满意,今介绍如下。
Reflux esophagitis is a common complication after esophageal and cardiac cancer resection and esophagogastric anastomosis. The reason is that the structure of the cardia area is removed and the anti-reflux physiological function of the esophagogastric system is destroyed. In recent years, many well-known thoracic surgeons have designed many anti-reflux surgical procedures such as pyloric plasty, nested esophagogastric anastomosis, posterogastric gastric fundoplication anastomosis, fundoplication valvuloplasty, and anastomosis. Intercostal muscle bundle suspension and so on, but the effect is not ideal, and extended the operation time or increase the difficulty of surgery. In our hospital from May 1980 to May 1982, according to the anatomical and physiological mechanisms of esophageal anti-reflux, we used a method of reconstructing the anti-reflux function of the esophagus and stomach, that is, embolization of esophagogastric anastomosis with gastric esophagitis. Combined with gastric fundoplasty, 20 cases were performed and the anti-reflux effect was satisfactory. This is described as follows.