SU1729499A1 - Method for establishing an esophagoenteroctomy - Google Patents

Abstract

This invention relates to esophageal surgery. The goal is to prevent peritonitis and reflux esophagitis. The loop of the small intestine is carried out in the window of the mesentery of the large intestine. Put the food in the bottom of the small intestinal anastomosis end to the side with the distant knee of the intestine. The retractable knee is bent proximally and fixed to the esophagus. Sew along the side walls of the esophagus and both knees of the intestine between themselves. Impose inter-intestinal anastomosis. 1 il.

Description

The invention relates to medicine, namely to surgery of the esophagus, and can be used during gastroectomy.

The aim of the invention is the prevention of peritonitis and reflux esophagitis.

The goal is achieved by the fact that after the application of the esophageal-intestinal anastomosis, the diverting knee of the small intestine is bent in the proximal direction, stitching it to the muscle wall of the esophagus and stitching the resulting and withdrawing knee of the intestine with the side walls of the esophagus and between them.

The drawing shows the scheme of the anastomosis.

The method is carried out as follows.

After gastroectomy, the loop of the small intestine is carried out in the mesentery window of the large intestine, the distal end of the esophagus is hemmed to the diverting knee of the loop of the small intestine. Then impose

the esophageal-enteric anastomosis end to the side between the esophagus and the outlet knee of the small intestine. After that, the diverting knee of the small intestine, forming a physiological turn through 180 °, is bent, being placed proximally on the anterior wall of the esophagus, covering the entire mobilized part of it, and fixing it to the muscular wall of the esophagus. Then, the gray-muscular layer of both loops of the small intestine and the muscle layer of the esophagus are stitched together with interrupted sutures along its side walls. Thus, a cap is put out of the loops of the small intestine and is put on the end of the esophagus. The operation ends with the insertion of an inter-intestinal Brown anastomosis.

Example. Patient S., 58 years old, was admitted 08: 09.1987 to the surgical department of the Gorky Road Hospital with complaints of aching epigastric pain, weight loss, loss of appetite, and aversion to meat. Sick himself considers techeso

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half a year, when abdominal pains first appeared. September 17, 1987, under endotracheal anesthesia, gastrectomy was performed with the application of an anti-reflux esophageal-small intestinal anastomosis using the described procedure. The postoperative course is smooth. Stitches are you for 11 days. Healing by primary tension. With Р-scopy from 10/02/1987, the anastomosis permeability is good, there is no contrast injection into the esophagus, the patient is in a satisfactory condition after the operation, and does not present any complaints. General clinical analyzes at discharge without pathology.

The operation was successfully performed in 20 patients, there were no complications.

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Claims (1)

Invention Formula The method of forming the esophageal-small bowel anastomosis, including the formation of a fistula with the diverting knee of the small intestine loop and plastic sheathing of the suture line, characterized in that, in order to prevent peritonitis and reflux esophagitis, during plastic shelter the outlet knee is bent in the proximal direction by stitching it to the muscle wall of the esophagus and stitching the resulting and outgoing knees of the intestine with the side walls of the esophagus and among themselves.