Germain M, Arsac M
Ann Otolaryngol Chir Cervicofac. 1980 Mar;97(3):189-99.
A technique of oesophago-jejunostomy in the neck is described using an isoperistaltic jejunal Y loop with added vascularisation from the internal mammary vessels via microsurgical anastomoses. This technique is used either for solely palliative purposes when the tumour is inoperable, or after oesophagectomy as a method of reconstruction of the digestive tract. An experimental study in the dog of replacement of the cervical oesophagus using a free gastric, jejunal or colonic transplant indicates the possibility of envisaging these techniques in the near future in man after circular total pharyngo-laryngectomy. The importance of these modern technique made possible by microsurgery is of two types: --value in adequate treatment of the tumour, since the resection can be extensive, the length of the graft being such that the whole of the oesophagus can be replaced; --functional value since the result is immediate and of good quality.
本文描述了一种颈部食管空肠吻合术,采用等蠕动空肠Y形袢,并通过显微外科吻合术增加来自胸廓内血管的血供。当肿瘤无法切除时,该技术仅用于姑息治疗;或在食管切除术后作为消化道重建的一种方法。在狗身上进行的一项实验研究,使用游离胃、空肠或结肠移植替代颈段食管,表明在环状全咽喉切除术后,近期有可能在人体应用这些技术。显微外科使这些现代技术得以实现,其重要性体现在两个方面:——在肿瘤的充分治疗方面具有价值,因为切除范围可以很广,移植段的长度足以替代整个食管;——功能价值,因为结果立竿见影且质量良好。