Movchan B. Prevention of suture failure of esophageal anastomoses during esophagoplasty

Work is based on the analysis and synthesis of the results of examination and surgical treatment of 121 patients with cicatricial stricture of the esophagus postburns in department of surgery of esophagus, stomach and intestines in National Institute of Surgery and Transplantology named by A. A. Shalimov of National Academy of medical sciences of Ukraine from 1999 to 2009. Studied the morphological changes that occur in the esophageal anastomoses, depending on the used for its formation suture material. Based on the results of the proposed set of measures aimed at prevention of suture failure of esophageal anastomoses, which includes: correction of protein metabolism formation of gastrostoma execution and its closure after restored through the mouth; pre-and postoperative sanation oropharyngeal with antiseptic solutions. Formation of esophageal anastomosis, not earlier then 6 months after the burn of the esophagus; additional using of epidural anesthesia; formation the transplantant from the colon; preparation of artificial esophagus long enough to form the cervical anastomosis using a stapler; realization of one stage of esophagoplasty; formation of esophageal anastomoses using a circular stapler device (head diameter 28-29 mm); adequate correction of irregularities and complications that arose after surgery.What has reduced the incidence of failure of esophageal anastomosis from 30 to 3.2%.