Kawai K I, Kakibuchi M, Sakagami M, Fujimoto J, Toyosaka A, Nakai K
Department of Otolaryngology, Hyogo College of Medicine, Japan.
Ann Plast Surg. 2001 Oct;47(4):390-3. doi: 10.1097/00000637-200110000-00005.
Total esophageal reconstruction using a gastric tube is complicated because it sometimes causes postoperative complications such as anastomotic leakage, stenosis, or fistula formation resulting from insufficient blood flow at the distal end. To overcome this problem, during the past 5 years the authors performed seven additional microvascular anastomoses using the short gastric vessels of the gastric tube. No postoperative complications occurred except partial tracheal necrosis in 1 patient. Postoperative radiographic examination showed no reflux or stasis in all patients, and no evidence of necrosis at the anastomotic site of the pulled-up gastric tube was observed by postoperative endoscopy. This technique reduces risk and may contribute to the successful reconstruction of the digestive tract after total esophagectomy.
使用胃管进行全食管重建手术较为复杂，因为它有时会导致术后并发症，如吻合口漏、狭窄或由于胃管远端血流不足而形成的瘘管。为克服这一问题，在过去5年中，作者利用胃管的胃短血管又进行了7例微血管吻合术。除1例患者出现部分气管坏死外，未发生其他术后并发症。术后影像学检查显示所有患者均无反流或淤滞情况，术后内镜检查未发现上提胃管吻合部位有坏死迹象。该技术降低了风险，可能有助于全食管切除术后消化道的成功重建。
