摘要
目的探讨经腹改良杉浦术式的应用价值。方法对1997年5月～2003年5月期间经腹改良杉浦术45例进行回顾性分析。手术操作如下切脾后,紧贴胃壁或食管壁行近半胃及食管下段的去血管化,保留左、右迷走神经干、Latarjet前、后神经及食管旁静脉。再于贲门远侧3～5cm平面缝扎黏膜下血管,或用管状吻合器在贲门上方3cm处将食管壁切断再吻合。结果本组无手术死亡,术后自由门静脉压力及血流速度改变不明显,而门静脉主干血流量明显减少(P<001)。缝扎组术后70%病例食管静脉曲张程度明显改善,30%完全消失,而吻合器组术后食管曲张静脉均消失。结论经腹改良杉浦术效果与原术式相近,而操作大大简化。
Objective To evaluate the advantage of transabdominal modified Sugiura procedure Methods We retrospectively analyzed 45 cases undergoing transabdominal modified Sugiura procedure from May 1997 to May 2003 The procedure included devascularization of near half gastric and inferior part of esophagus after splenotomy The left and right vagus nerves, the anterior and posterior Latarjet nerves and paraesophageal collateral veins were left intact The gastric submucous vasculature was sutured on the plane 3～5 cm distal to cardia (suture group); or the esophagus 3 cm above cardia was cut and reanastomosed with pipe anastomat Results There was no inhospital mortality Free portal veinous pressure and portal vein flow speed did not change significantly The flow volume of portal vein decreased ( P <0 01) The esophageal varix improved (70%) or disappeared (30%) in the suture group, while it all disappeared in anastomat group Conclusions The procedure of transabdominal modified Sugiura′s was significantly simplified, and the short term result is satisfactory
出处
《中华普通外科杂志》
CSCD
北大核心
2004年第11期651-652,共2页
Chinese Journal of General Surgery
