valve tube gastrostomy

Valve-type gastrostomy is modified according to the principle of tubular gastrostomy, and a flap is created on the base of the "stomach tube" to prevent the contents of the stomach from overflowing. Treating diseases: esophageal cancer Indication 1. Esophageal cancer can not be surgically removed, can be used as a symptom relief surgery. It is estimated that the survival period is longer than 3 months, and permanent gastrostomy may be feasible; if the survival time is shorter than 3 months, temporary gastrostomy is performed. 2. In patients with benign esophageal stricture, temporary gastrostomy may be performed as a preparatory operation to facilitate subsequent thorough surgery or dilatation treatment. 3. Some patients with special abdominal surgery, postoperative temporary gastrostomy, early decompression, can be used later to feed, help patients recover. Contraindications The patient is too old and should be filled with poor general condition. Preoperative preparation Patients with esophageal obstruction can not eat for a long time before surgery. They are often malnourished. They must be fully infused and transfused to correct dehydration and anemia, improve nutrition, enhance tolerance to surgery and ensure wound healing. Surgical procedure 1. The patient is supine: generally use the left upper transabdominal rectus incision, about 6 ~ 8cm long. The upper mid-abdominal incision can also be used, and the ostomy tube can be extracted from the side of the lateral abdominal wall. A flap is selected in the anterior wall of the stomach, but the base of the flap should be on the small curved side. 2. Manufacture of gastric wall flap: a straight forceps is placed across the predetermined base of the valve, and the muscle wall of the anterior wall of the stomach is sutured intermittently with a thread to make the stomach wall protrude into the cavity into a flap [Fig. (1)] . 3. Make a "stomach tube": U-shaped incision of the anterior wall of the stomach, insert a F18 tube into the stomach cavity 5 ~ 7cm, suture the margin of the gastric wall flap along the entire layer of the catheter, and add a layer of pulp muscle layer intermittent suture , complete the stomach wall with pedicle "stomach tube" 4. Lead out the "stomach tube": on the outer edge of the left rectus abdominis, a small mouth is placed on the abdominal wall under the assist margin, and its position is preferably higher than the base of the "stomach tube" to avoid overflow of the stomach contents. The "stomach tube" is taken out through the small mouth, and the stump should be exposed to the skin 0.5cm, and the wall of the tube and the surrounding peritoneum, fascia and skin are sutured with a few needles. Finally, the abdominal wall incision is sutured. complication Gastrointestinal discomfort.