Bueno R, Swanson S J, Jaklitsch M T, Lukanich J M, Mentzer S J, Sugarbaker D J
Division of Thoracic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Gastrointest Endosc. 2001 Sep;54(3):368-72. doi: 10.1067/mge.2001.117517.
Esophageal strictures that cause complete obstruction are often difficult to dilate with standard bougienage techniques.
A new technique was developed and applied, combined antegrade and retrograde dilation, for dilatation of complex esophageal strictures. The stomach is accessed and an endoscope (9.8 mm diameter) is directed under fluoroscopy in a retrograde fashion into the distal esophagus. A guidewire with a hydrophilic coating is advanced through the stricture and then pulled through the mouth with a simultaneously placed proximal endoscope. The guidewire is then used as a guide for antegrade esophageal dilatation.
Ten patients with complex esophageal strictures (with and without fistulas) were treated with this technique. Three required a second combined antegrade and retrograde dilation procedure. All strictures were dilated and no perforations occurred.
Combined antegrade and retrograde dilation is a safe and effective technique for dilation of complex obstructing esophageal lesions.
导致完全梗阻的食管狭窄通常难以用标准的探条扩张技术进行扩张。
开发并应用了一种新技术，即顺行和逆行联合扩张，用于扩张复杂的食管狭窄。进入胃腔，将直径9.8毫米的内镜在荧光透视引导下逆行插入食管远端。将带有亲水涂层的导丝穿过狭窄部位，然后通过同时插入的近端内镜从口腔拉出。然后将导丝用作顺行食管扩张的引导。
10例复杂食管狭窄（有或无瘘）患者接受了该技术治疗。3例患者需要进行第二次顺行和逆行联合扩张手术。所有狭窄均成功扩张，未发生穿孔。
顺行和逆行联合扩张是一种安全有效的扩张复杂梗阻性食管病变的技术。
