METHOD OF COLOGASTRIC ANASTOMOSIS WITHIN ESOPHAGOPLASTY WITH LARGE INTESTINE

摘要

FIELD: medicine; surgery. ^ SUBSTANCE: subtotal esophagectomy and proximal partial gastrectomy is carried out suturing three machine stitches. The first machine stitch is arranged at an obtuse angle to greater curvature of stomach and to the second machine stitch. Thus fornix of ventricle is formed. The third machine stitch is arranged towards duodenum. The second machine stitch is distanced to leave space for anastomosis. Transplant is rotated so that its mesentery is directed to machine stitch towards duodenum. Circular incision of seromuscular tunic is applied canwise on aboral end of colonic transplant making distance 10 mm from mesenteric vessels and 35-40 mm from antimesenteric edge. Between transplant and lesser curvature of gastric stump two suturing lines are provided invaginating distal intestine fragment below circular incision in gastric stump lumen as duplication. His angle is formed by fixing formed fornix of ventricle to colonic transplant. ^ EFFECT: method allows for prevention of gastric contents reflux to colonic transplant and related complications; for lower risk of suture lack development in cologastric anastomosis and for adequate functional result of operation. ^ 5 dwg, 1 ex