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[食管良性病变初次手术干预失败后的矫正]

[Correction of failed primary surgical interventions in benign lesions of the esophagus].

作者信息

Gerzić Z, Pesko P, Knezević J, Simić A, Stojakov D, Sabljak P, Radovanović N

机构信息

Institut za digestivne bolesti KCS, Beograd I hirurska klinika Medicinskog fakulteta Centar za ezofagogastricnu hirurgiju Srbije.

出版信息

Acta Chir Iugosl. 2001;48(1):13-23.

Abstract

In an retrospective analysis of documentation and printed paper in period between 1964-1998 168 patients required reoperations in benign esophageal lesions. Failed initial interventions were found in 66 (39.28%) pts. operated in our clinic and 102 (60.71%) pts operated in other institutions in our country. The corrective procedure was possible in 140 (83.33%) pts and impossible in 11 (6.54%). Post-operative mortality was 7.73% so the definitive failed corrections were 14.27%. The main cause of failure were: Defective operative technique, wrong preoperative diagnosis and indications including inadequate initial procedure. Among the 168 pts undergoing corrective surgery, more than a half of pts had obstructive lesions requiring resections and reconstructions. Dilatation of the stricture was possible in 16% followed by total diversion, particularly in previous gastric surgery. Malignant degeneration of benign lesions were found in 10.71%. Only 4 pts (2.3%) refused suggested operations. Satisfactory long-term results especially in patients undergoing esophageal corrective reconstructions for benign diseases were good to excellent in regular yearly postoperative routine control examination.

摘要

在一项对1964年至1998年间的文献和印刷资料进行的回顾性分析中,168例良性食管病变患者需要再次手术。在我院接受手术的66例(39.28%)患者和在我国其他机构接受手术的102例(60.71%)患者中发现了初次干预失败的情况。140例(83.33%)患者可以进行纠正手术,11例(6.54%)患者无法进行。术后死亡率为7.73%,因此最终失败的纠正率为14.27%。失败的主要原因包括:手术技术有缺陷、术前诊断和适应证错误,包括初始手术不充分。在接受纠正手术的168例患者中,超过一半的患者有梗阻性病变,需要进行切除和重建。16%的患者可以进行狭窄扩张,其次是全转流,特别是在既往有胃手术史的患者中。良性病变的恶性变发生率为10.71%。只有4例(2.3%)患者拒绝了建议的手术。在每年定期的术后常规检查中,尤其是在接受良性疾病食管纠正重建手术的患者中,长期效果令人满意,从良好到优秀。

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