myotomy of the cardia

Cardiomyotomy is a surgical procedure for the treatment of cardia disease, including transabdominal cardiotomy, transthoracic myotomy, and cardia incision. It is suitable for patients with cardia achalasia who have failed medical treatment or combined with other esophageal lesions. The best treatment time: general surgery is recommended to be treated after the initial diagnosis of the disease, special surgery should be prescribed. Treatment of diseases: achalasia in children with achalasia Indication Patients with cardia achalasia who have failed medical treatment or have other lesions of the esophagus. Contraindications No relevant information. Preoperative preparation 1. Rinse the esophagus 3 days before surgery. 2. Oral esophageal anti-inflammatory drugs are taken after the hospital. 3. Enter the clear liquid diet 3 days before surgery. Surgical procedure (a) transabdominal cardiac muscle incision 1. Position: supine position. 2. Incision: The median or paramedian incision in the upper abdomen. 3. Cut the peritoneum between the cardia and the ankle, free the lower part of the esophagus, and pull it down with a gauze strip. The lower esophageal and cardia muscle layers were longitudinally cut between the left and right vagus nerves. 4. The upper end of the myometrial incision should include a 2 cm dilatation esophagus; the lower end reaches the esophagus and stomach junction. In order to make the esophageal mucosa naturally bulge, the esophageal ring muscle must be completely cut off and the muscle layer and the mucosa should be separated for more than 1/2 week. 5. Stop bleeding carefully and check for gastric mucosal damage by gastric injection. Once it is found to be damaged, it should be repaired with a thin wire. If the damage is large and difficult to repair, it can be changed to cardia or cardia. (B) transthoracic myotomy Applicable to the achalasia with other esophageal lesions, such as esophageal diverticulum, hiatal hernia or esophageal cancer can not be excluded. 1. Position: right lateral position. 2. Incision: the 7th rib or the 8th intercostal incision of the posterior aspect of the left chest. 3. The muscle layer incision operation is the same as above. (3) Cardiac incision operation transverse suture 1. Position: right lateral position. 2. Incision: the 7th rib or the 8th intercostal incision of the posterior aspect of the left chest. 3. If the mucosal damage is severe during the incision of the transthoracic and sacral muscle layer, and the repair cannot be repaired, the full layer of the cardia can be cut 2-3 cm vertically. 4. At the midpoint of the two sides of the incision, a needle pull line is drawn at each point, and after the cut, the two sides are pulled to the side, so that the longitudinal incision becomes a transverse incision, and then the whole layer is interrupted and the suture is horizontally sutured. 5. Interstitial suture of the muscle layer. complication Wound infection.