Collis Gastrectomy

Collis gastrostomy is to cut the fundus along the esophagus and suture again to increase the His angle and re-establish the abdominal esophagus. If the esophageal stricture is combined, the esophageal dilatation should be performed 2 weeks before surgery. If there is no reflux of gastric juice after operation, it can be gradually widened, which is a better surgical method for treating reflux esophagitis. Treatment of diseases: gastroesophageal reflux disease Indication Collis gastrostomy is suitable for: 1. Reflux esophagitis with esophageal scar stenosis or acquired esophageal shortening. 2. Patients with obesity reflux esophagitis. 3. Recurrent reflux esophagitis (applying other surgical failures). Contraindications 1. The nutritional status is low and no correction is obtained. 2. Cardiopulmonary function is poor, it is not suitable for this operation. 3. There are active lower esophageal bleeding. 4. Severe scar stenosis of the esophagus in the abdominal segment, and it is estimated that partial esophagectomy should be performed. Preoperative preparation 1. Diet therapy, acid-resistant treatment, bed elevation 20 ° during sleep, so that reflux esophagitis is in a stable state. 2. Correct anemia and hypoproteinemia before surgery. 3. Control airway inflammation and stop smoking. 4. Lower stomach tube before surgery. Surgical procedure 1. Before anesthesia is intubated, the esophagus is dilated with a 50F esophageal probe, and the probe is left in place, or the probe is removed, and a catheter is inserted as a sign of the esophagus. 2. The posterior thoracic incision of the left chest enters the chest through the 7th or 8th intercostal space. 3. Cut the lower lung ligament and pull the left lower lobe above. The mediastinal pleura was incised at the level of the lower pulmonary vein, the esophageal membrane was opened, and the lower esophagus was removed and the traction was pulled. 4. Expose the diaphragm and esophageal hiatus, and separate the short blood vessels of the stomach and the left gastric artery branch, so that the fundus is completely free. 5. Lift the stomach into the chest and place the cutting stapler against the esophageal probe. The small curved tube after suturing is approximately equal to the thickness of the esophagus. The newly extended esophageal lower end was wrapped by the Belsey No. 4 method or the Nissen method, and the fundus and the dome were sutured and fixed by two needles. complication 1. Pulmonary complications are mostly caused by cough. 2. Abdominal wound infection, underarm abscess, postoperative bleeding, etc.