METHOD FOR DEVELOPING AREFLUX CERVICAL ESOPHAGEAL-LARGE INTESTINAL ANASTOMOSIS
FIELD: medicine, surgery. SUBSTANCE: transplant is made retrosternally. At distal esophageal end muscular pulp is formed by separating and folding upwards muscular esophageal membrane. About 4-5 sutures are applied onto posterior semicircumference of the upper edge of muscular pulp and countermesent...
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Zusammenfassung: | FIELD: medicine, surgery. SUBSTANCE: transplant is made retrosternally. At distal esophageal end muscular pulp is formed by separating and folding upwards muscular esophageal membrane. About 4-5 sutures are applied onto posterior semicircumference of the upper edge of muscular pulp and countermesenteric edge of large intestine. About 4-5 sutures are applied onto posterior semicircumference of the lower pulp's edge and the upper edge of serousmuscular membrane. Intestinal lumen is lanced. About 4- 5 sutures are applied onto posterior semicircumference of the lower edge of muscular pulp and the upper edge of serous-muscular membrane. Intestinal lumen is lanced by leaving 15-20 mm below inferior edge of muscular pulp to cross esophageal mucosa. Submucosal and mucosal membranes of esophagus and large intestine are sutured. Free edge of esophageal mucosa is invaginated into transplant's lumen. About 5-6 sutures are applied onto inferior edge of anterior semicircumference of pulp and intestinal edge. About 6-7 sutures are applied onto superior edge of anterior semicircumference of pulp and serous intestinal membrane. The present method enables to decrease the risk in developing anastomosis failure. EFFECT: higher efficiency. 6 dwg |
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