OESOPHAGOGASTRIC ANASTOMOSIS TECHNIQUE

摘要

FIELD: medicine.;SUBSTANCE: greater curvature of stomach is mobilised; a tubular stomach graft is formed of the greater curvature of stomach from fundus of stomach at 2.0-3.0 cm from the pyloric portion. The oesophagus is separated with a nonabsorbable ligature applied and a part of the oesophagus and lesser curvature of stomach preserved below the ligature. The graft is delivered to the pleural cavity and fixed by interrupted sutures to the diaphragm. One line of the separate interrupted sutures is applied to suture the oesophagus longitudinally with the tubular stomach graft. The walls of the oesophagus and the tubular stomach graft are perforated above the oesophageal ligature. The perforation edges are joined and extended additionally. A prepared compression clamp is introduced through said perforations so that one of its branches is embedded in the oesophageal cavity, and the other - in the cavity of the stomach graft. The compression anastomosis based on a thermal shape memory effect of said compression clamp which is arranged in parallel to the axis of the oesophagus and the stomach graft, i.e. by "side-to-side" type. The primary anastomotic patency is restored by dissecting tissues inside the clamp. The external perforation edges are closed. The second line of separate serous-muscular interrupted sutures is applied on the anterior semicircle of the anastomosis.;EFFECT: method allows reducing intraoperative injuries, simplifying operative technique, and reducing risk of inconsistency of the anastomosis.;14 cl, 16 dwg