[Supra-aortic arch esophagogastrostomy through esophageal bed in treating patients with middle and lower esophageal carcinoma].
A new surgical procedure of esophagogastrostomy was carried out in 162 cases with middle or lower thoracic esophageal carcinoma in our department from January, 1992 to December, 1994. Esophagogastrostomy was performed at supra-aortic arch site by pulling the stomach along the esophageal bed instead of putting it before aortic arch in the thoracic cavity. The procedure may keep the normal physiological function of the organs in the chest. It may help fully distend the left lung so as to reduce impairement of pulmonary function because the thoracic stomach was kept within the mediastinum. No resection mortality or anastomotic leakage occurred in the series. Since the esophagus and the stomach were anastomosed in a linear fashion without angulation, the evenly distributed intracavitary pressure may help prevent anastomotic leakage from occurrence. It is also easy to be dilated if anastomotic stricture occurs. In addition, the new procedure may be helpful in promoting gastric emptying, preventing gastric reflux, depressing and stopping the blood oozing in the mediastinum and air leakage from the ruptured lungs, as well as in distinguishing pleural effusion from gastric retention. Compared with other procedures, it is more difficult to perform the anastomosis. Once anstomotic leakage occurs, drainage is not easy.
Yang
L
L
Department of Thoracic Surgery, Cancer Hospital/Institute, Chinese Academy of Medical Sciences, Beijing.
Zhang
R
R
Mao
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000601:surgery*