RU1777834C - Small intestine anastomosis application method - Google Patents

Abstract

The purpose of the invention is to improve the function of the anastomosis by increasing its elasticity. A loop of the jejunum over 6-7 cm is sutured with the mesenteric edges. The formed duplicate is sutured horizontally to the posterior-lateral walls of the esophagus at the diaphragm. Anastomosis is formed, with sutures through all the layers of the esophagus and intestine, around the entire circumference of the anastomosis, capture the adducting intestine along its anti-mesenteric surface. On the anterior and lateral sections of the anastomosis, the upper edge of the adrenal gut is sutured to the food ode and diaphragm and the lower one - to the abducting intestine 3 il

Description

The invention relates to medicine, in particular to surgery, and can be used for total removal of the stomach

The aim of the invention is to improve the function of the anastomosis by increasing its elasticity

The goal is achieved by suturing the peritoneal edges with the leading and diverting loops of the intestine and stitching them horizontally to the posterior-lateral walls of the esophagus near the diaphragm, and when anastomosing the esophagus with the abducting intestine with serous-muscular sutures around the circumference, the anastomosis grasps the antispecific of the intestine, then its upper edge is sutured to the esophagus and diaphragm and the lower to the abducting intestine

In Fig. 1, sewing of the duplicate of the small intestine to the posterior wall of the esophagus is shown; in Fig. 2, the formation of the posterior lip of the anastomosis with the capture of the serous-muscular layer leading to each seam

loops in Fig 3 - the beginning of the formation of the anterior lip of the anastomosis

The method is as follows

After removal of the stomach, the esophagus is held with a curved clamp. A loop of the small intestine is passed through a window in the mesentery of the transverse colon and 30–35 cm from the Treytz ligament, the leading and diverting intestines are sutured along 6-7 cm of the peritoneal edges into in the form of a double-barreled shotgun With three sutures, the formed duplicate in a horizontal position is sutured to the posterior-lateral walls of the esophagus near the diaphragm. The esophagus is anastomosed with a horizontally located discharge intestine. of this circumference of the anastomosis capture the adducting intestine along its ant mesenteric surface. On the front and lateral sections of the anastomosis, the upper edge of the adrenal gut of the hem

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they are attached to the esophagus and diaphragm, and the lower to the abducting intestine. The operation is completed by applying the intestinal anastomosis according to Brown about the fixation of this anastomosis in the window of the mesocolon.

The method was developed experimentally and applied in 11 patients.

Example, Patient N., 48 years old, medical history Ne 3830, was operated on for cancer of the body of the stomach. A gastroectomy was performed. Esophageal-enteric anastomosis was performed according to the described procedure. The postoperative course is smooth, I began to take food on the 3rd day. Discharged from the clinic on the 14th day in satisfactory condition. A month after discharge, a control endoscopic examination was performed. Slight hyperemia in the area of anastomosis is noted, there are no data for reflux esophagitis.

None of the operated patients developed anastomotic insufficiency. When examining at a later date after surgery, all patients showed good anastomotic function, its absence

narrowing and deformity, the absence of reflux esophagitis.

Claims (1)

SUMMARY OF THE INVENTION A method for applying an esophageal-enteric anastomosis, comprising forming a duplicate from the jejunum, stitching the esophagus with the outlet knee of the duplicate, stitching the top of the duplicate with the esophagus and lead loop, characterized in that, in order to improve the function of the anastomosis by increasing its elasticity around the entire circumference of the anastomosis, the serous-muscular layer of the adducting knee of the duplicate is captured into the sutures, for which it is fixed horizontally to the back wall of the esophagus, then the sutures forming the anastomosis are sutured through all layers the edge of the cross section of the esophagus, capture serous-muscular the layer leading the loops and again through all the layers the edge of the intestinal incision, tying the threads with nodules inward, after which the upper edge of the apex of the duplicate is fixed to the esophagus and diaphragm, and the lower to the outlet gut. Cabbage soup g Fig.Z