Miroshnikov B I, Labazanov M M, Kalivo E A, Pavelets K V
Khirurgiia (Mosk). 1996(6):4-8.
Inadequate blood supply is one of the major reasons of esophageal anastomosis incompetence. The authors have examined esophageal blood supply as regards of the operative technique. The esophageal vascular system was studied by the method of intraarterial impregnation in 40 cadavers. Two segments, crucial for esophageal anastomosis, have been determined: retropericardial segment in case of the lower esophageal artery ligation and the upper segment of the thoracic esophagus in case of its extreme mobilization in proximal direction and ligation of lower thyroid arteries. The results of 175 operations were analysed. The direct correlation between the frequency of anastomotic incompetence and the level of its formation was determined. In the zone with an inadequate blood supply the complication occurred in 4 patients of 25 (16%). In other cases the rate of incompetence was 3.2%. No cases of incompetence were observed in 61 patients after anastomosis was performed with due regard for esophageal blood supply.
血供不足是食管吻合口功能不全的主要原因之一。作者从手术技术方面对食管血供进行了研究。采用动脉内灌注法对40具尸体的食管血管系统进行了研究。确定了对食管吻合至关重要的两个节段：在结扎食管下动脉的情况下为心包后节段，在食管向近端极度游离并结扎甲状腺下动脉的情况下为胸段食管上段。分析了175例手术的结果。确定了吻合口功能不全的发生率与其形成部位之间的直接相关性。在血供不足的区域，25例中有4例（16%）出现了并发症。在其他情况下，功能不全的发生率为3.2%。在61例手术中，由于考虑到食管血供进行了吻合，未观察到功能不全的病例。
