Subtotal esophagectomy, external placement and gastrostomy (jejunostomy)

Perforation of the esophagus for more than 24 hours, often due to rancid infection in the mediastinum and pleural cavity and severe inflammatory edema of the esophageal wall, it is difficult to complete the first-stage suture repair. According to the location, severity and physical condition of the perforation of the esophagus, corresponding measures and operations should be taken to control and reduce the source of pollution, and to promote the improvement of the general condition and the healing of the perforated esophagus. Common surgical methods include patch repair of esophageal perforation, cervical, mediastinal or thoracic drainage, total thoracic esophagectomy, cervical esophagus and gastrostomy, and esophageal lumen management. Treatment of diseases: esophageal injury Indication Most of the esophagus, external and gastric (jejunal) ostomy are suitable for: 1, transthoracic closed drainage and antibiotic application is still difficult to control the mediastinum and chest infection, the wounded are generally better, can tolerate thoracotomy. 2, extensive and serious esophageal injury. Surgical procedure 1. Suck the pleural effusion after the chest and rinse thoroughly. The mediastinal pleura was dissected, and the thoracic esophagus was freed. The esophageal hiatus was slightly dissociated downward, the esophagus was cut, and the cardia was sutured closed. 2, anterior incision of the sternocleidomastoid, the thoracic esophagus is taken out through the neck incision. 3, flush the chest cavity, if the closed drainage of the thoracic cavity is improper, it should be adjusted by another incision. Place antibiotic solution in the chest and close the chest. 4, abdominal incision for stomach or jejunostomy.