Luketich J D, Grondin S C, Pearson F G
Section of Thoracic Surgery, UPMC Health Systems, Pittsburgh, PA 15213, USA.
Semin Thorac Cardiovasc Surg. 2000 Jul;12(3):173-8. doi: 10.1053/stcs.2000.9597.
Acquired shortening of the esophagus remains a controversial finding. In some surgical series of patients with gastroesophageal reflux disease, the incidence of clinically significant shortening is low enough that some surgeons have questioned its existence. In the setting of massive hiatial hernia, esophageal shortening has been reported to occur in up to 100% of patients. In association with mild to moderate hiatal hernia, clinically significant esophageal shortening is reported from 2.6% to a much higher percentage of patients, depending on the severity and chronicity of gastroesophageal reflux disease. Failure to recognize this shortening may be responsible for a high failure rate after antireflux surgery. Open Collis gastroplasty is an effective way to manage acquired shortening of the esophagus, and it creates a tension-free intra-abdominal segment of neoesophagus for fundoplication. Minimally invasive approaches to Collis-Nissen procedures have been reported by our group and several others with good short-term results.
后天性食管缩短仍是一个存在争议的发现。在一些胃食管反流病患者的外科手术系列中，具有临床意义的缩短发生率低到一些外科医生质疑其存在。在巨大食管裂孔疝的情况下，据报道高达100%的患者会发生食管缩短。与轻至中度食管裂孔疝相关时，根据胃食管反流病的严重程度和病程，有临床意义的食管缩短发生率报道为2.6%至更高比例的患者。未能识别这种缩短可能是抗反流手术后高失败率的原因。开放式科利斯胃成形术是处理后天性食管缩短的有效方法，它为胃底折叠术创建了一个无张力的新食管腹内段。我们团队和其他几个团队都报道了科利斯-尼森手术的微创方法，短期效果良好。
