Bakirov A A
Vestn Khir Im I I Grek. 2001;160(1):53-7.
An analysis of immediate and long-term results of surgical treatment of 170 patients with esophageal obstruction is presented. Esophagoplasty with different fragments of the gastrointestinal tract was used (87--ileocolon, 16--small intestine, 23--left half of the colon, 44--a stalk from the greater curvature of the stomach). The greater amount of complications due to incompetence of the esophageal anastomosis sutures was noted in patients after esophagoplasty with a fragment of the small (50%) and right half of the large (59.7%) intestine, more rarely-after plasty with a gastric stalk (15.9%) and left half of the colon (26.1%). There was no necrosis of the transplant from the left half of the colon. Severe ischemic lesions made their appearance in the fundal portion of the gastric stalk (2.2%), necrosis of the small intestine part of ileocolon developed in 16.1% of the patients. In the patients with less amount of postoperative complications one-stage esophagoplasty was performed. Reconstructive operations on the artificial esophagus were necessary in 43.6% of the patients. The main indication for it was mechanical dysphagia.
本文对170例食管梗阻患者的手术治疗近期和远期结果进行了分析。采用了不同胃肠道段的食管成形术(87例采用回结肠,16例采用小肠,23例采用左半结肠,44例采用胃大弯带蒂组织)。在采用小肠段(50%)和右半结肠段(59.7%)进行食管成形术的患者中,因食管吻合口缝线功能不全导致的并发症较多,而采用胃带蒂组织成形术(15.9%)和左半结肠成形术(26.1%)的患者并发症较少。左半结肠移植组织未发生坏死。胃带蒂组织的胃底部出现严重缺血性病变(2.2%),16.1%的患者回结肠的小肠部分发生坏死。术后并发症较少的患者进行了一期食管成形术。43.6%的患者需要对人工食管进行重建手术。其主要指征为机械性吞咽困难。