摘要目的 观察食管、贲门癌切除后,食管、胃肌层、粘膜不同平面分层吻合方法(简称:分层吻合法)预防吻合口瘘、狭窄及返流三大并发症的作用.方法 对2002年2月至2008年12月间施行的126例食管、贲门癌切除食管、胃肌层、粘膜不同平面分层吻合方法的手术及术后1年随访资料进行分析,并与同期及前期所施行的单层宽边吻合、隧道式吻合及器械吻合法的同类并发症发生资料进行对比.结果 全组无吻合口瘘发生.术后1年内随访,临床症状正常者占85%～98%,钡餐造影显示吻合口宽度在1.0 cm以上者达98.4%,镜下见吻合口处粘膜光滑、扩张良好者占80%.与同期其他几种吻合方法同类并发症发生率比较P＜0.05差异均有显著意义.结论 食管、胃肌层、粘膜不同平面分层吻合法用于食管、贲门癌切除后消化道重建,具有较好地预防吻合口瘘、狭窄和返流作用,简单、实用,是一种值得推荐的吻合方法.

abstractsObjective To observe layered suture of esophageal-gastric muscularis & mucous on non one plane(LSEGMMP)plays a role in preventing the anastomotic leakage,stricture and backflow after excising the esoplageal and cardiac carcinoma.Methods Analysing the following-up data of 126 cases of esophagealgastric muscularis and mucous on non one plane layered suture after excising the esoplageal and cardiac carcinoma form February 2002 to December 2008,and compares with single and wide anastomosis,tunnel anastomosis and instrumental anastomosis during this time and the foretime.Results No anastomotic leakage,The normal clinic is 85%-98%,the widths of anastomotic opening over 1.0 cm is 98.4% through barium meal and expand well in gastroscopes is 80%.The layered suture of esophaged-gastric muscularic & mucous on non one plane has the significance difference compared with other three methods(P＜0.05).Conclusion The layered suture of esophaged-gastric muscularic & mucous on non one plane(LSEGMMP)can better prevent the anastomotic leakage,stricture and backflow after excising the esoplageal and cardiac carcinoma.It is a worth skill about rebuild of alimentary canal verygood functional and simple.