SURGICAL TREATMENT METHOD FOR ACHALASIA OF CARDIAC ESOPHAGUS

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, in particular to abdominal surgery. The esophagus is mobilized with separation of middle bundle of the right branch of esophageal hiatus (EH). Mobilize EH left branch back from the esophagus until its complete isolation. The lower third of the esophagus is isolated from posterior mediastinum by separation and blunt separation from mediastinal pleura. The mobilized esophagus is lowered and fixed to the right and left EH branches. Access is carried out in vascular-free zone behind EH to posterior wall of the stomach floor with the intersection of short gastric vessels. Starting from the cardiac part of the stomach at a distance of 1.5-2 cm from the cardioesophageal junction, an anterior esophagocardiomyotomy is performed up the esophagus with a length of 6-9 cm. A fundoplication cuff is formed by stitching the anterior wall of the stomach floor to the left side of the esophagocardiomyotomy incision throughout, followed by fixing the same wall to the right side of the esophagocardiomyotomy incision throughout. Then a posterior partial half-sleeve is formed by holding the stomach posterior wall behind the esophagus and fixing it to the right wall of the lower third of the esophagus of the cardiac stomach with at least two nodular sutures. Perform posterior crurography along the diameter of esophagus. ;EFFECT: method reduces risks of intraoperative and postoperative complications, reduces number of disease relapses, allows to straighten pathological bends of esophagus, and also prevents development of the main complication of cardiomyotomy, especially gastroesophageal reflux disease (GERD) and gastroesophageal hernia (GEH).;1 cl, 8 dwg, 3 ex