Subbotin V M, Plaksin S A
Grud Serdechnososudistaia Khir. 1990(2):64-7.
Thirty-three operations for subtotal esophagectomy with one-stage plastics with a gastric pedicle without thoracotomy were carried out between 1985 and 1988. The indications for the operation were as follows: carcinoma of the esophagus (17) and of cardioesophageal localization (7), cicatricial stricture of the esophagus (6), IV degree cardiospasm (2), unspecific esophageal ulcer (1). The esophagus was resected through a laparotomo-transdiaphragmatic-cervical access, the graft formed from the greater curvature of the stomach was passed in the posterior mediastinum with the establishment of a cervical esophagogastroanastomosis. Postoperative complications occurred in 29 patients: incompetence of the anastomosis (26), mediastinitis and pyothorax, (4), peritonitis (2), pneumonia (4). Six patients died. With the performance of intrapleural esophagogastroplasty the mortality rate fell from 25 to 18.2%. The authors claim that subtotal esophagectomy with posteromediastinal gastroplasty without thoracotomy is a less traumatic and safer operative intervention.
1985年至1988年间，共进行了33例不做开胸手术的一期带蒂胃食管次全切除术。手术适应症如下：食管癌（17例）、贲门食管部癌（7例）、食管瘢痕性狭窄（6例）、IV度贲门痉挛（2例）、非特异性食管溃疡（1例）。通过经腹-经膈肌-颈部入路切除食管，取自胃大弯的移植物经后纵隔引出，在颈部行食管胃吻合术。29例患者出现术后并发症：吻合口功能不全（26例）、纵隔炎和脓胸（4例）、腹膜炎（2例）、肺炎（4例）。6例患者死亡。采用胸膜内食管胃成形术后，死亡率从25%降至18.2%。作者认为，不做开胸手术的后纵隔胃成形术式的食管次全切除术是一种创伤较小且更安全的手术干预方式。
