METHOD OF ESOPHAGEAL-ENTERIC ANASTOMOSES FORMATION AT SURGICAL TREATMENT OF CARDIOESOPHAGEAL CANCER Russian patent published in 2010 - IPC A61B17/11 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely, surgical oncology, and can be used for surgical treatment of cardioesophageal cancer with gastrectomy. The jejunum distal end after its transsection is sutured with stapled and serous-muscular purse-string sutures, dislocated behind the stump of the esophagus in the sagittal plane and the jejunum distal end is fixed with two rows of sutures - three in each - the first suture is in the middle, then the lateral ones. Then a diametrical enterotomy in the mediastinum of 6-7 cm distance from the jejunum sutured end is made. Rear and front walls of the anastomosis are formed with inner loop sutures from the base of esophagus mucous membranes and small intestine with the capture of the submucous layer and "muscular ridge" of the esophagus. The esophagus is invaginated to the intestine by consistent development of semipurse-string sutures with use of pleural sutures of posterior wall - first distal and then proximal. Then "П"-shaped sutures are overcasted with a transverse shoulder on the esophagus front wall, and then they are tied from right to left, and simultaneously the esophagus to the jejunum is invaginated. The anastomosis formation is finalised with suturing of jejunum blind end mesenterium using threads of two "П"-shaped sutures, after tightening of which "gas bubble is formed moving the blind end of jejunum above the anastomosis zone without the tension of tissues.

EFFECT: method provides simplification of manipulation in the mediastinum cavity, significantly reduces rate of anastomosis front wall insolvency, giving anastomotic properties of valve mechanism and thereby ensuring optimal functional results in postoperative period.

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