FIELD: medicine; surgery.
SUBSTANCE: oesophagus is anastomosed sideward of abduct intestinal loop. Anastomosis is peritonized with adduct small intestinal loop. Oesophagus stump is fixed to diaphragm with lavsan figure-of-eight sutures. "Window" is formed inside of mesentery selected for anastomosis of small intestinal loop between straight vessels. Ends of lavsan suture mesentery are sutured by ends of formed "window". Oesophagus stump is taken through mesenteric "window" while lavsan sutures are tightened providing fixation of small intestinal loop to diaphragm by mesentery. Adjacent walls of intestinal loop and oesophagus stump are sutures shaping intestine as closed loop with sphincter on oesophagus stump beyond oesophageal-intestinal anastomosis. Oesophagus stump laid along adduct knee of small intestinal loop and anastomosed sideward of cross-dissected adduct small intestinal loop with single-layer suture. Abduct and adduct knees of small intestinal loop are serous sutured above oesophagus stump and anastomosis. Method enables to prevent ineffeiciancy of esophago enteroanastomosis sutures, provides free passage through anastomosis, prevents entero-esophaguereflux, reflux esophagitis, peptic complications of oesophagus and anastomosis, prevents hernia of esophageal opening with oesophageal-intestinal anastomosis shift above diaphragm.
EFFECT: preventing of postoperative complications.
12 cl, 1 ex
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Authors
Dates
2008-06-27—Published
2006-11-13—Filed