[Application of isolation traction of aortic arch and upper part of the thoracic aorta in operation on cancer of the esophagus].
Isolation traction of aortic arch and upper part of thoracic aorta was performed by pulling and rotating them rightwards during operation on cancer located in the mid-segment of esophagus with serious adhesions. In 35 patients operated on, 33 cancers were resected with resection rate of 94%, including 21 by radical resection (60%) and 12 by palliative operation (34%). The method was to isolate the aortic arch and the upper part of thoracic aorta sufficiently and ligate the severed intercostal arteries and veins securely. While isolating the aorta, we pulled and rotated it with a strip of bandage and exerted strength evenly and gently as long as the operation field was exposed clearly. Otherwise, the heart function may be compromised. When isolating the aorta, a slight drop of blood pressure could be observed in some cases. It could recover immediately as we stop pulling and replaced the aorta in situ. According to our clinical experience, its advantages were: 1. It can prevent and treat the bleeding of hemiazygos vein. None of the 33 patients with adhesion and infiltration between the tumor and hemiazygos vein bled during the operation, even with the hemiazygos vein torn and bleeding. Bleeding could be stopped with ease because of good exposure; 2. It can extend the limit of resection and raise the resection rate; 3. It can broaden the space between the aorta and esophagus which is convenient for esophagogastrostomy on the esophagus bed, and 4. It can secure ligation of thoracic duct to prevent chylothorax.
Dong
W Z
WZ
Affiliated Hospital, Changzhi Medical College.
D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D014143:Traction