Wastell C, Cahill J
St. Stephen's Hospital, London.
Ann R Coll Surg Engl. 1987 Sep;69(5):216-9.
Successful surgical palliation for carcinoma of the cardia and lower oesophagus is often compromised by anastomotic failure or local recurrence. These complications follow technical difficulty in achieving adequate resection and a safe anastomosis through inappropriate surgical exposure, often via the left chest. A technique of oesophagogastrectomy is described employing a simultaneous right abdominothoracic approach without division of either costal margin or diaphragm. Synchronous laparotomy and thoractomy facilitates both resection and anastomosis, and obviates the necessity to turn the patient over and redrape halfway through the operation. Closure of the distal stomach and the gastro-oesophageal anastomosis are performed using staplers. No anastomotic leaks were detected in the 15 patients described.
贲门癌和食管下段癌的成功手术姑息治疗常因吻合口失败或局部复发而受到影响。这些并发症是由于通过不适当的手术暴露（通常经左胸）实现充分切除和安全吻合存在技术困难所致。本文描述了一种食管胃切除术技术，采用同时经右胸腹联合入路，不切开肋缘或膈肌。同步剖腹术和开胸术有利于切除和吻合，避免了手术中途将患者翻身并重新铺巾的必要性。使用吻合器进行远端胃闭合和胃食管吻合。在所描述的15例患者中未检测到吻合口漏。
