| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention relates to field of medicine, in particular to reconstructive surgery, and can be used in restoring integrity of laryngopharynx in case of its complete or partial absence in combination with vast defect of soft tissues of neck, as well as cervical esophagus. Plasty of laryngopharynx and cervical esophagus is carried out by means of visceral small intestinal-mesenteric transplant with preservation of mesentery in full volume. Vessels feeding transplant are anastomosed with neck vessels. Intestinal fragment of flap is placed into position of laryngopharynx in such a way that its opposite to mesentery edge was located relative neck midline on the other side of zone of microvascular anastomoses. Distal anastomosis is formed between intestinal tube of autotransplant and cervical esophagus. Oral fragment of intestine is folded in "L-like" way using its natural curves in such a way that length of horizontally located part of intestinal fragment corresponded to value of oropharynx lumen diameter. Fixing suture is applied between angle of intestinal fragment and adjacent wall of oropharynx. Fragmenbt of intestinal component of autotransplant is dissected in wedge-like manner on its opposite to mesentery edge in zone of orostoma. Proximal anastomosis is formed between intestinal tube and oropharynx. After that, by means of mesenteric fragment of flap isolated are lines of sutures in region of organ and microvascular anastomoses. By means of mesentery, adjacent to oropharynx, proximal anastomosis with intestine and microvascular anastomoses are covered. Remaining part of mesentery is used to isolate zone of esophago-intestinal anastomosis and mediastinum. ^ EFFECT: application of claimed invention makes it possible to restore integrity of organs of proximal part of digestive tract. ^ 1 ex, 3 dwg |
