Gerzic Z B
Department of Esophagogastric Surgery, Institute of Digestive Diseases, Belgrade, Serbia.
Dis Esophagus. 1997 Oct;10(4):270-5. doi: 10.1093/dote/10.4.270.
The jejunal interposition operation after resection of distal esophagus and cardia, designed by Merendino and Dilard, has not been widely employed until now. The complexity of the procedure, demanding high performance, and still unacceptable postoperative mortality, were limiting factors and a challenge for many surgeons. The aim of this paper is to present three modifications of the original technique, without changing the basic concept of the Merendino procedure. These modifications differ from the original technique in three main ways: the longer isoperistaltic jejunal segment, the terminolateral mechanical esophagojejuno anastomosis, and the placement of the lower jejunogastric anastomosis on the posterior wall of the stomach. This report comprises an experience in 29 patients operated on in period 1972 through 1995. There were two postoperative deaths and long-term results were excellent in all except one patient who had an ischemic stenosis of the transplanted jejunal segment. Despite this, the Merendino procedure, simplified by these modifications, deserves to be more frequently used in the treatment of undilatable or recurrent strictures and other benign lesions which require resection of the distal esophagus and cardia.
由梅伦迪诺（Merendino）和迪拉德（Dilard）设计的远端食管和贲门切除术后空肠间置术，至今尚未得到广泛应用。该手术操作复杂，要求较高的技术水平，且术后死亡率仍难以接受，这些都是限制因素，对许多外科医生来说是一项挑战。本文的目的是介绍对原始技术的三处改进，而不改变梅伦迪诺手术的基本理念。这些改进在三个主要方面与原始技术不同：更长的顺蠕动空肠段、端侧机械性食管空肠吻合以及胃空肠吻合术置于胃后壁。本报告包含了1972年至1995年期间对29例患者进行手术的经验。术后有两例死亡，除1例患者移植空肠段出现缺血性狭窄外，其他患者的长期效果均良好。尽管如此，经这些改进简化后的梅伦迪诺手术，在治疗不可扩张或复发性狭窄以及其他需要切除远端食管和贲门的良性病变时，值得更频繁地使用。
