摘要
目的:研究横结肠代食管治疗食管化学性烧伤后瘢痕狭窄的可行性,探讨影响此疗法预后的相关因素.方法:本组病例均采用保留横结肠左动脉升支和经胸骨后隧道顺横结肠蠕动方向重建食管,结肠食管颈部吻合、结肠咽腔吻合治疗食管化学性烧伤后瘢痕狭窄患者112例.患者手术时间为伤后3 wk^10 a,其中41例手术在伤后3~4 wk内进行.结果:本组无手术死亡病例.术后颈部吻合口瘘13例、吻合口狭窄8例,术后气管切开4例.经对症治疗后患者进普食均顺利.随访时间1~26 a,所有随访患者进食后无返流,平时口腔无粪臭味.结论:食管化学性烧伤后瘢痕狭窄患者应尽早采取食管重建手术治疗,以加强对患者术后常见病的预防.
AIM： To study the feasibility of esophageal recon- struction with transverse colon for caustic esophageal stricture induced by chemical burn and explore the factors related to prognosis. METHODS： From 1972 to 2006, 112 with full-length caustic esophageal stricture were treated surgically, in whom 92 underwent esophago-cologastrostomy and 20 colon-pharyngeal an- astomosis. The ascending branch of the left artery of the trans- verse colon was preserved as the supporting vessel of the inter-positioned colon. The operations were performed 3 weeks to 10 years after chemical burn, and among them, 41 cases received the operations 3-4 weeks after injury. RESULTS： There was no death in the operations. After operations, the leakage of anastomotic stoma occurred in 13 cases, the stenosis of anastomotic stoma in 8 cases and tracheotomy was performed in 4 cases. Follow-up study （ 1-26 years） revealed that all the patients grew normally, had no food regurgitation after eating and no odour of dung in oral cavity. CONCLUSION： Esophageal reconstruction with transverse colon by esophago-cologastrostomy or colon-pharyngeal anastomosis is an optimal approach to treat full-length caustic esophageal stricture induced by chemical burn, and it should be performed as early as possible to prevent the complications.
出处
《第四军医大学学报》
北大核心
2008年第12期1144-1146,共3页
Journal of the Fourth Military Medical University
关键词
食管狭窄
化学烧伤
瘢痕
横结肠代食管
esophageal stenosis
bums, chemical
cicatrix
esophageal replacement with transverse colon
