[Iatrogenic injuries of the cardia antireflux system]. / Jatrogenne uszkodzenia mechanizmu antyrefluksowego wpustu.

ABSTRACT

Among presented 18 patients with iatrogenic injury of the cardia antireflux system, 5 were females and 13 males aged 35-62 years of life. 13 cases were operated before for cardiospasmus, 5 had gastric resection B2 for duodenal ulcer. In consequence all the patients presented stricture of the thoracic lower and abdomen part of oesophagus. 16 patients required reoperations, 2 had dilatation. In 2 cases stricture were located in middle and lower part of oesophagus. In 4 cases in abdominal and supradiaphragmatic part of oesophagus, in 5 cases in abdominal part of oesophagus, and in 7 cases in the cardia. 11 patients required one corrective surgery, 4-two operations, and 1-three operations. As a final procedure in 2 cases artificial oesophagus was formed with intestinal graft, in 8 cases the cicatrical part of the oesophagus was excised and replaced by a pedunculated graft by Merendino method, in 3 cases esophagogastric anastomosis were done using Heyrowsky method, in 2 cases bypass was made from pedunculated part of jejunum which connect the part of oesophagus above the narrowing with the prepyloric part of the stomach by the own method, in 1 case intrathoracic esophagogastric anastomosis was performed. The best results were obtained by oesophagogastric bypass.