【摘要】 目的 探讨食管肿瘤、贲门癌行肿瘤切除后，以胃重建食管时食管-胃吻合技术的改进，预防吻合口瘘及狭窄的发生。方法 采用Gambee单层吻合法及全层间断单层吻合法交替应用。结果 采用此方法吻合的286例患者，吻合口瘘发生率2.7%(4/146)，吻合口瘢痕狭窄0.7%。未出现胸腔内吻合口瘘及近期吻合口狭窄。结论 此法适用于食管-胃吻合术，特别适用于贲门癌胃切除较多的弓下食管-胃吻合术及食管癌切除食管-胃颈部吻合术。迄今，在广泛应用吻合器的情况下，手法缝合食管、胃吻合仍是外科医生必须熟练掌握的基本功，本文介绍的改良Gambee吻合法有推广应用价值。

    【关键词】 吻合术；改良法；食管-胃吻合；瘘；狭窄

    The application of an improved Gambee anastomotic method

    LIU De-hua,HU Li-hua.Chinese Medicine Hospital of Tai’an City,Tai’an 271000,China

    【Abstract】 Objective Inquiring into the improvement of esophagus-stomach anastomosis when the esophagus is supported by the stomach and rebuilt cardiac cancers postures are cut,to prevent fistula and narrowness growing out of anastomotic cut.Methods Unlined Gambee anastomotic method alternates with all-layer-disconnecting unlined anastomotic method.Results Among the 286 cases cured by the anastomotic method,the percentage of neck fistula from the anastomotic cut is 2.7%(4/46),and the rate of scar narrowness from the anastomotic cut is 0.7%.There is no thoracic fistula or short -stomach anastomosis,esp.for arch exophagus-stomach anastomosis when a larger part of the stomach is cut because of cardiac cancers and for esophagus-stomach neck anastomosis is still a basic skill for surgeons,though anastomotic instruments are widely used today.Conclusion Therefore,the improved Gambee anastomotic method introduced in this essay is still worth spreading and applying in medical practice. ......