胸壁前食道胃吻合時の特殊胃瘻に就て

概要

論文の詳細を見る
In treating cancer of the esophagus in the upper and middle thorax with definitive operation, esophagogastrostomy in the front of the thoracic wall has provided the most satisfactory result in our department, with a mortality of 2.1 per cent. Perforation of anastomosis, which has occurred in 61.0 per cent of the patients operated on with this procedure, is the accident most commonly encountered. For the purpose of preventing this accident, the author developed a technic of making a special gastric fistula. The internal pressure of the gullet newly created in the front of the thoracic wall, the fluctuation of which is the cause of perforation, was measured and expressed in pressure curves, and the amount of intraluminal air was determined. And their influences on alimentary passage were investigated roentgenologically. The intraluminal bacteria were also studied. These studies indicated that the best location for the fistula would be a point 7 cm distal from anastomosed portion. This technic was used in 23 cases. This gastric fistula proved to be of value in preventing perforation of anastomosis. It facilitated feeding of patients at an early postoperative period, immobilization of anastomosed portion, irrigation, and adjustment of intraluminal pressure. When used in 9 cases of secondary anastomosis, the technic achieved a success in all of them. Elimination of air and administration of food were made so easier by this technic that the time required for giving food has been cut to one third of what it had taken previously. When this technic was employed, patients could do without nasal sound and had low incidence of complications. The fistula usually closes in one week after removal of the tube. This technic of making a gastric fistula has replaced the use of nasal sound as a standard technic in our department.
千葉大学の論文

胸壁前食道胃吻合時の特殊胃瘻に就て

スポンサーリンク

概要

著者

関連論文

スポンサーリンク