Kirschner surgery

Kirschner surgery is a bypass procedure that does not remove the tumor and performs an esophagus, stomach and neck anastomosis. Treatment of diseases: tracheoesophageal fistula Indication Kirschner surgery is suitable for: 1. The general condition of the patient is still good. It is estimated that the tumor is difficult to be removed and the patient has severe obstruction. 2. Surgical exploration confirmed that the tumor could not be removed, especially through the exploration of esophageal hiatus, and the tumor could not be removed. 3. Esophageal tracheal fistula, the patient is generally better. Preoperative preparation The preparation range includes the neck, chest and abdomen. Surgical procedure Intratracheal intubation was general anesthesia. The patient was placed in a supine position with a small pillow under the shoulder, the head tilted back, and turned to the right. 1. Fully dissipate the stomach and duodenum, and keep the right gastric artery and the right aortic valve arch of the gastric retina. 2. Perform pyloric angioplasty. 3. At the esophagogastric junction, the cardia is routinely sutured and closed, and the jejunum at 45 cm from the flexor ligament is lifted up to the end of the end esophagus. Roux-en-y surgery can also be used. 4. Take a oblique incision along the anterior border of the sternocleidomastoid muscle, free the cervical esophagus, cut the esophagus, and suture the distal end. 5. The stomach is lifted through the chest subcutaneous tunnel to the neck and the esophagus, and the anastomosis method is the same as the general neck esophagogastric anastomosis. 6. Place the rubber under the skin under the skin and suture the neck and abdomen incision.