2．食道再建術の基本手技：胃管再建

Basic Technique of Reconstruction after Esophagectomy by Gastric Tube

食道癌手術における再建術は，ほかの消化管手術と比べ，多くの手技上のポイントが存在する．①再建臓器，②再建経路，③吻合法に加え，胃管再建では形状が問題となる．本稿では，胃管再建に絞って基本手技につき解説する．

Reconstruction after esophagectomy for esophageal cancer is concluded with 3 factors like as choice of organ, construction route and anastomotic method. The stomach is commonly preferred as a reconstructive organ at over 80％ hospitals in Japan. This is known as the gastric tube. But, there are 3 types of a gastric tube as a whole stomach, a sub-whole stomach and a narrow gastric tube. Surgeons should choice a proper type under these characteristics of a reconstructive distance and a blood flow. In our hospital, we use a sub-whole stomach willingly through post sternal route. The rate of anastomotic leakage was 2.7％．And there were no problems to raise up to cervical side. Still more, it is referred to the problem between reconstructive route.