METHOD FOR ESOPHAGOPLASTY WITH COMBINED VISCERAL GRAFT AFTER SUBTOTAL ESOPHAGECTOMY IN COMBINED ESPOGENOD AND STOMACH LESIONS Russian patent published in 2022 - IPC A61B17/11 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery, and can be used in reconstructive surgery of the esophagus after subtotal esophagectomy with combined lesions of the esophagus and stomach. To do this, after subtotal esophagectomy and resection of the stomach, a gastric graft is formed in the form of a gastric tube, cutting it off from the duodenum while maintaining the feeding pedicle of the right gastroepiploic vessels. A small intestinal insert 20 cm long is formed on the third pair of jejunal arteries, followed by its transfer to the upper abdominal cavity through the window into the mesocolon, preventing the vascular pedicle from twisting along the axis. After that, a single-row "end-to-end" gastrojejunoanastomosis and a two-row "end-to-end" gastrojejunoanastomosis are sequentially formed. An incision is made on the neck along the medial edge of the left sternocleidomastoid muscle and the cervical esophagus is mobilized, followed by its removal to the neck and intersection. The formed gastrointestinal graft is passed through the posterior mediastinum to the neck, the excess stump of the cervical esophagus and the gastrointestinal graft is cut off and a two-row "end-to-end" esophagogastroanastomosis is formed with separate interrupted sutures.

EFFECT: method provides full nutrition through the mouth while maintaining the duodenal passage due to the formation of a combined graft on a natural source of blood supply, as well as reducing the risk of esophageal anastomosis failure due to the formation of a two-row anastomosis in the area of ​​the most favorable blood supply to the graft, in conditions of combined damage to the esophagus and stomach.

1 cl, 8 dwg, 2 ex