METHOD OF ANTIREFLUX PROTECTION AND EARLY ENTERAL NUTRITION OF PATIENTS WITH ESOPHAGUS DAMAGE AND RUPTURES COMPLICATED BY INTESTINAL DEFICIENCY SYNDROME

摘要

FIELD: medicine; surgery.;SUBSTANCE: fundoplication together with singular gastrostomy is performed. Stomach antireflux protection is realised with preservation of anatomical continuance of gastrointestinal tract. Suture fixating fundoplication gorge is additionally amplified by the second row of single seromuscular sutures. Gastric cone is attached to the abdominal wall by six additional single sutures. Three-line gastrointestinal probe is introduced intraoperationally through a stomach opening to the distance of 70-80 cm, to reach behind the Treitz fascia. Then a gastrostomic sleeve is drawn over the probe. The sleeve is placed in the gastric lumen in direction. Stomach end of the sleeve is directed to the cardia and positioned over the fluid level at the stomach bottom region. This method provides technical simplicity with minor traumatic effect of interference at the single-stage operation, possibility to combine functions of antireflux protection, decompression and nutritive support, to begin enteral nutrition at early post-operation period, and to perform intestinal deficiency syndrome treatment, to alleviate rehabilitation period for patients.;EFFECT: reliable stomach-to-esophagus reflux prevention and gastrostoma sealing with preservation of its decompression function with the help of sleeve bifurcation.;1 ex, 1 dwg