Objective To discuss the technical keypoints of the second-phase diaplasis treatment after Hartmann operation. Methods Twenty-one cases of the second-phase diaplasis operation of Hartmann operation in this hospital from January 2003 to December 2007 were analysed retrospectively. Results In this group, stapler technique was used in 15 cases, anastomotic ring was used in 3 cases, and one-layer suture was used in 3 cases. The time of these operations was between 118 min and 240 min (mean 164 min). Neither stomal leak nor stomal stenosis occurred, acute ileus occurred in 2 cases, and both recovered after the treatments of gastrointestinal decompression, inhibition of secretion digestive juice and reoperation. Acute retension of urine occurred in 1 case after urine catheter removed. The symptoms disappeared after excises of bladder function. These cases were followed up for 3-36 months (mean 20 months). All the patients recovered to normal function of defecation. Conclusion The technical keypoints of the second-phase diaplasis treatment after Hartmann operation are how to find and liberate the end of the distal colon. It will affect the prognosis and the occurrence of complications after this operation.

Objective To investigate the effect of 3S jejunal interposition anastomosis in digestive tract reconstruction after radical resection for early gastroesophageal junction adenocarcinoma. Methods One hundred and eighteen patients of early gastroesophageal junction adenocarcinoma who were planned to receive radical proximal gastrectomy from February 2011 to August 2015 were prospectively enrolled and randomly divided into two groups by table of random number, including observation group (3S jejunal interposition) and control group (esophageal remnant gastric posterior wall anastomosis), with 59 patients in each group. Postoperative complications, operative time, nutritional parameters and postoperative quality of life were compared between two groups. Results The operation time in observation group was (152.3 ± 13.1) min, in control group was (146.0 ± 12.5) min, and there was no significant difference (P>0.05). The rate of complication in observation group was 8.5%(5/59), in control group was 13.6%(8/59), and there was no significant difference (P>0.05). The levels of total protein, albumin, hemoglobin, and Vitamin B126, 12, and 18 months after operation in observation group were significantly higher than those in control group (P<0.05). The rate of reflux esophagitis 6, 12 and 18 months after operation in observation group was significantly lower than that in control group (P<0.05). The gastric emptying time 6, 12 and 18 months after operation in observation group was significantly prolonged, compared with that in control group (P<0.05). The scores of whole quality of life, emotional function, body function, pain, tired, appetite, nausea and vomiting, diarrhea and constipation 6 and 18 months after operation in observation group were significantly better than those in control group (P<0.05). Conclusions The 3S jejunal interposition anastomosis in digestive tract reconstruction after radical resection for early gastroesophageal junction adenocarcinoma is a better method. The effect of antirelux is better and can improve the nutriture and quality of live for long time.