“Thanks to the Chest Hospital for giving me a second life, now I not only have a healthy life, but also gain happiness, really I feel very fortunate.” Recently, Li Zhigang, deputy director of the thoracic surgery department of Shanghai Chest Hospital and director of the esophagus subspecialty department, received a special wedding photo.
It is hard to imagine Mr. Li, the groom with a bright smile in the photo, who was completely unable to eat five years ago and lost his life. Courage to live. When he was desperate, Director Li Zhigang’s team used the superb technique of reconstructing the digestive tract with free jejunum interposition, and reconstructed the “vital of life” for him. This is the first patient successfully treated with this technology since the establishment of the esophagus subspecialty of the Chest Hospital.
“I’d rather die like this.” Five years ago, Mr. Li was only 18 years old. Because of severe chemical injury to the esophagus, he underwent gastric replacement esophagus surgery at a local hospital. Unexpectedly, the operation failed, not only failed to cure his esophagus injury, but also made his digestive tract “disjointed” and unable to eat.
Is it true that you can only live by infusion of nutrient solution for the rest of your life? When Director Li Zhigang received the consultation, the young man was unhappy and too thin to be human.
“Don’t be discouraged, it can be cured! We will help you connect the esophagus.” After careful evaluation and multidisciplinary discussions, the esophageal surgical team formulated a surgical plan for “reconstruction of the digestive tract with free jejunum interposition”.
Learning that there is hope for treatment, Mr. Li’s family was moved to tears.
As early as 1976, Professor Huang Oulin, the founder of the Department of Chest Hospital, led the team to complete the first case of free jejunum interposition neck digestive tract reconstruction + microvascular anastomosis in China. This kind of operation cuts out a section of jejunum and transplants it to the incomplete esophagus, which can maintain the anatomical integrity and physiological function of the upper gastrointestinal tract to the greatest extent, so that the patient can obtain a better quality of life.
However, the operation is very difficult. In addition to the reconstruction of the digestive tract, it is also necessary to complete the delicate vascular anastomosis to ensure the survival of the transplanted jejunum. For example, if our esophagus is compared to an apple tree, the cut jejunum is a “peach branch”. Doctors need to graft the “peach branch” onto the apple tree to ensure its nutrient supply and keep it growing. .
“This is a classic and complex surgical technique, which not only has extremely high technical requirements for the surgeon’s operation, but also It also requires very tacit teamwork. Our hospital has carried out extensive and accumulated rich clinical experience in the treatment of benign and malignant esophageal diseases such as localized cervical esophagus cancer, hypopharyngeal cancer and intractable stenosis of cervical anastomotic stoma after esophagectomy. , all have unique advantages.” Director Li Zhigang introduced.
On the day of Mr. Li’s surgery, the doctors first removed the damaged esophagus, then cut a section of jejunum from the patient’s abdominal cavity and “transplanted” it to the neck. The diameter of the blood vessels in the jejunum is only 3mm. Through exquisite microsurgical techniques, Director Li Zhigang carefully anastomosed the jejunum with the cervical arteries and veins at the upper and lower ends, so that the “peach branches” can get blood supply smoothly and survived. Rebuild was successful!
After careful postoperative care and rehabilitation, Mr. Li was soon discharged from the hospital.
He got the joy of eating by mouth again, a long-lost smile appeared on his face, and he ushered in a new life.
As a well-known domestic center for the diagnosis and treatment of difficult and complicated esophageal diseases, the Chest Hospital has now carried out a large number of colonic replacement esophageal cancer operations for the treatment of recurrent esophageal cancer, esophagogastric dual-origin cancer and esophageal chemical injury, free Jejunal interposition in the treatment of high cervical esophagus and hypopharyngeal carcinoma, salvage esophagectomy after radical chemoradiotherapy, total resection of pharynx, larynx and esophagus for digestive tract reconstruction, complicated esophagotracheal fistula surgery, pediatric esophagus surgery and other difficult operations .
“Tube” well, life is better! The esophagus surgery team adheres to the fine traditions of its predecessors, focuses on difficult, severe and complex diseases, and actively develops various advanced, sophisticated and cutting-edge new technologies for diagnosis and treatment, and makes unremitting efforts towards the goal of building the largest esophageal disease diagnosis and treatment center in the city and even in southern China.
Author: Tang Wenjia Deng Tian
Editor: Tang Wenjia
Responsible editor: Fan Liping
*Wenhui Exclusive manuscript, reprint please indicate the source.