Grillo H C, Wilkins E W
Ann Thorac Surg. 1975 Oct;20(4):387-99. doi: 10.1016/s0003-4975(10)64235-x.
Multiple techniques, often complex, have been used to repair the esophagus following spontaneous, instrumental, or postsurgical perforation, especially when the diagnosis of perforation has been delayed. We have closed such perforations by wrapping a pedicled pleural flap around the esophagus, suturing it firmly over the area of leakage and around its margins. Due to inflammatory changes secondary to perforation, the flap is thickened and easily applied. Four patients were treated with this technique with success in every case. One patient with achalasia had sustained perforation three days prior to repair, another 30 hours following leakage at an esophageal suture line, the third 20 hours following esophagoscopic extraction of a necrosing foreign body, and the fourth 8 hours following hydrostatic bougienage for achalasia.
多种技术，通常较为复杂，已被用于修复自发性、器械性或手术后食管穿孔，尤其是当穿孔诊断被延迟时。我们通过将带蒂胸膜瓣包裹在食管周围，在漏口及其边缘牢固缝合，成功闭合了此类穿孔。由于穿孔继发的炎症改变，胸膜瓣会增厚且易于应用。4例患者采用该技术治疗，均获成功。1例贲门失弛缓症患者在修复前3天发生持续性穿孔，另1例在食管缝线处漏液后30小时发生穿孔，第3例在食管镜下取出坏死异物后20小时发生穿孔，第4例在贲门失弛缓症行水压扩张术后8小时发生穿孔。
