www.heavensgatel2.fora.pl

[nlwxpearo]

Transanal resection of rectal adenoma surgery experience


Resection of esophageal cancer on the pleural experience of 34 cases of Wuhan Iron and Steel Company s = level I hospital of thoracic surgery (430,085) Yanyuan Zhi Wang Xu Xu Hui: Off ■ words】 esophageal cancer; radical surgery [Chinese sub-Lou No.】 R6554 [Document ID M A bud】 【article number] 1005-6483 (2001) 04-0264 A O11996 ~ 1999 years, we have the line in the lower esophageal carcinoma patients with esophageal carcinoma, total resection of thoracic esophagus,[link widoczny dla zalogowanych], stomach on behalf of the esophagus, a total of 34 cervical anastomosis down. Prayer from esophageal surgery,[link widoczny dla zalogowanych], do not cut the pleural arch, good results are reported below. J Peng clinical material in this group were 28 males and 6 females down. The average age of 57 years Preoperative Barium swallow examination. Fiber esophageal endoscopy. Living tissue pathology. Were diagnosed as esophageal squamous cell carcinoma. 5 feet down the middle of one of esophageal cancer. 11 down the lower thoracic esophageal cancer. 18 lower esophageal chest down. Twenty lesions 2 ~ l1 n. Operation line on the left thoracotomy. Cut diaphragm. Debate away from the esophagus and stomach, the neck re-cut r1. Respectively, stomach, esophagus through the space, the bow raised to the neck. Full cut thoracic esophagus. Agreement on behalf of esophagus stomach and neck. All cases occurred in only 1 patient rl cervical anastomosis fistula, wound drainage after open time, after dressing, Ding fistula closed, and the remaining patients had no complications, the prognosis is good, 1-year survival of 28 down. Survival rate of 82.0%. Discussed in the past such surgery. Prayer of the process from the esophagus, are required to cut the top of the aortic arch on chest pleura, well exposed to free the esophagus. Free to the neck and then after this, put the esophagus to the neck on the line to kiss sets. We repeatedly over a long period of clinical study of surgical procedures have been improved, not cut intraoperative pleural arch by arch up the blunt edge of the wall along the free food. Direct neck. Rl by the neck and then cut down along the wall of blunt free food, both of Department of Taiwan,[link widoczny dla zalogowanych], respectively intrathoracic esophagus, stomach tucked up to the neck. Yo neck cancer resection combined line. Cao D I think this method has many advantages. First, shorten the operation time. Pleural cut bow, Zhou Yi!} Can be free under the direct ligation of esophageal soap surrounding tissue, reducing bleeding, but it is not. Free bow to the neck because of the esophagus after the process, the possibility of bleeding esophageal bed is actually very small. This is determined by anatomical factors. Cervical esophagus usually from the left and right inferior thyroid artery artery in the neck incision under the soap in the direct ligation. Thoracic esophagus. Aortic arch near the lower edge of the most abundant blood supply of the esophagus region. The most important cross-border lines arch arteries, the more the bow Only by pooling the blood vessel network. Do not cut it on the pleural arch. Prayer does not result from blunt esophageal bleeding esophageal bed possible. The operation time is greatly reduced. Second, reduce the side injury in the left thoracic aortic arch l deadlock on the thoracic esophagus short. Located by the ridge Zhu. The upper edge of the aortic arch and subclavian artery posterior triangular area formed (Poifie ~ triangle). The triangle is from the edge of the subclavian artery was distributed directly to the bow above the bridge of the mediastinal pleura coverage. Traveling left intercostal veins superficial to the triangle. Pay attention level was thoracic duct. In this area. Thoracic duct upward from back to front around the left side of the esophagus. Javascript artery into the outer bone of the neck sorrowful. Usually when the cut to close to the bow after the pleura make longitudinal incision. Can only avoid the thoracic duct to avoid injury. In addition, more than in the aortic arch and esophageal tracheal membrane affixed to the front of the Ministry of floc. Tightly connected with the mediastinal pleura on both sides,[link widoczny dla zalogowanych], the left rear and adjacent to the recurrent laryngeal nerve. Have led to the sharp dissection of structural damage. Breast milk appears to the police, tracheal fistula, pneumothorax, and complications such as recurrent laryngeal nerve injury can be irregular. The blunt free, however, avoided this possibility. Three to prevent the chest fistula. Well known. Pleural fistula in the event hekou advised, the mortality rate is very high. So we are taking cervical anastomosis. However, the emergence of neck fistula. Part of the transudate pleural still leaking through esophageal bed. Led to a series of clinical symptoms. Especially in the bow on the chest cut open the top of the case of the pleura. We take no cut of intraoperative pleural arch. Makes Poi6e ~ Triangle region in the early postoperative closed. Leakage of irrigation Buzhi Yu neck ridicule hekou flow chest. To prevent the occurrence of thoracic fistula has played a positive role. L cases in this group appears cervical anastomotic fistula patients, thanks to the above method. And timely open wound drainage. Patients who were chest tightness, heart palpitations, shortness of breath and other symptoms. By dressing a good recovery. To sum up. Lower in the radical surgery of esophageal cancer to the pleural arch is not cut total resection of thoracic esophagus,[link widoczny dla zalogowanych], cervical anastomosis can not only shorten the operation time. Vice-injury can also be reduced to a minimum, and to good effect against breast fistula. f Author] Wu Yuanzhi (1959 a), male. Deputy chief physician