Vasudevan Sanjeev A, Kerendi Faraz, Lee Hanmin, Ricketts Richard R
Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
J Pediatr Surg. 2002 Jul;37(7):1024-6. doi: 10.1053/jpsu.2002.33834.
BACKGROUND/PURPOSE: The authors report the incidence, diagnosis, and treatment methods of congenital esophageal stenosis (CES) at their institution.
A retrospective analysis of 123 patients with tracheoesophageal anomalies in a pediatric hospital between 1980 and 1999 was performed. Charts were reviewed for patient demographics, presence of true CES, associated congenital anomalies, method of diagnosis, methods of treatment, and histopathology.
Six of the 123 patients (4.9%) had true CES (one patient had 2 separate stenoses). Two patients had isolated CES, one patient had CES with isolated tracheoesophageal fistula (TEF), one patient had CES with isolated esophageal atresia (EA), and 2 patients had CES with EA/TEF. Diagnoses were made with an upper gastrointestinal (GI) contrast study in 5 patients, and one patient had one of 2 stenoses diagnosed by prenatal ultrasound and the other diagnosed intraoperatively. Four of the 7 stenoses were treated with surgical resection, and the remainder was treated with esophageal dilatation. Histopathology from the 4 resected stenoses showed tracheobronchial remnants in 3 specimens and submucosal thickening in 1 specimen.
Although isolated CES is rare (2 of 123 = 1.6%), CES associated with other tracheoesophageal anomalies has a higher incidence (4 of 123 = 3.25%). Patients with this lesion should be treated first with dilatation. If ineffective, resection is required.
背景/目的：作者报告了其所在机构先天性食管狭窄（CES）的发病率、诊断及治疗方法。
对一家儿科医院1980年至1999年间123例气管食管畸形患者进行回顾性分析。查阅病历以了解患者人口统计学资料、真性CES的存在情况、相关先天性畸形、诊断方法、治疗方法及组织病理学情况。
123例患者中有6例（4.9%）患有真性CES（1例患者有2处独立狭窄）。2例患者为孤立性CES，1例患者为CES合并孤立性气管食管瘘（TEF），1例患者为CES合并孤立性食管闭锁（EA），2例患者为CES合并EA/TEF。5例患者通过上消化道（GI）造影检查确诊，1例患者的2处狭窄中1处通过产前超声诊断，另1处通过术中诊断。7处狭窄中有4处接受了手术切除，其余接受了食管扩张治疗。4例切除狭窄的组织病理学检查显示，3份标本中有气管支气管残余，1份标本中有黏膜下增厚。
虽然孤立性CES很少见（123例中有2例 = 1.6%），但与其他气管食管畸形相关的CES发病率较高（123例中有4例 = 3.25%）。患有这种病变的患者应首先接受扩张治疗。如果无效，则需要进行切除。
