Hordijk Marjan L, Siersema Peter D, Tilanus Hugo W, Kuipers Ernst J
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre Rotterdam, The Netherlands.
Gastrointest Endosc. 2006 Jan;63(1):157-63. doi: 10.1016/j.gie.2005.06.016.
Anastomotic esophageal stenoses after esophageal resection are common and sometimes are refractory to Savary bougie dilation. The efficacy of electrocautery needle-knife treatment in these patients is described.
Twenty patients with a refractory anastomotic stricture of the esophagus were treated with electrocautery and were followed for 12 months. All patients had recurrence of dysphagia despite repeated bougienage.
All 12 patients with a stricture shorter than 1 cm remained without dysphagia after a single treatment. In all 8 patients with a long-segment stenosis of 1.5 to 5 cm, dysphagia recurred, and a mean of 3 treatments were necessary. The interval between electrocautery treatments was significantly longer compared with bougienage. There were no complications. The body weight of all patients increased.
Electrocautery seems to be a good single-treatment modality for refractory short-segment anastomotic strictures, whereas longer-segment stenoses appear to require repeated treatment sessions before similar results are obtained.
食管切除术后吻合口食管狭窄很常见，有时对Savary探条扩张术无效。本文描述了电灼针刀治疗这些患者的疗效。
20例难治性食管吻合口狭窄患者接受电灼治疗，并随访12个月。尽管反复进行探条扩张术，所有患者仍有吞咽困难复发。
12例狭窄长度小于1cm的患者单次治疗后均无吞咽困难。8例长段狭窄1.5至5cm的患者吞咽困难均复发，平均需要3次治疗。与探条扩张术相比，电灼治疗之间的间隔明显更长。无并发症发生。所有患者体重均增加。
电灼似乎是治疗难治性短段吻合口狭窄的一种良好的单一治疗方式，而长段狭窄似乎需要反复治疗才能取得类似效果。
