腐蚀性损伤后的食管重建：右半结肠成形术还有一席之地吗？
Esophageal reconstruction after caustic injury: is there still a place for right coloplasty?
作者信息
Bothereau Hervé, Munoz-Bongrand Nicolas, Lambert Benoît, Montemagno Sébastino, Cattan Pierre, Sarfati Emile
机构信息
Department of Digestive and Endocrine Surgery, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75010, Paris, France.
出版信息
Am J Surg. 2007 Jun;193(6):660-4. doi: 10.1016/j.amjsurg.2006.08.074.
BACKGROUND
Through a systematic policy of using the right colon as an esophageal substitute, the authors analyze the reliability of this transplant for reconstruction after digestive caustic injury.
METHODS
From 1995 to 2005, a right coloplasty was attempted in 81 patients after total esophagogastrectomy (n = 57) or for esophageal stricture (n = 24).
RESULTS
The use of the right colon was not possible in 10 patients (12%) because of insufficient blood supply. In addition, postoperative right colic graft necrosis occurred in 5 patients. Cervical fistula occurred in 25 patients (31%). Opening of the thoracic inlet was associated with a lower rate of this complication (P = .04). At the end of the follow-up, 71 patients (88%) recovered oral feeding.
CONCLUSION
Attempt to use the right colon as an esophageal substitute failed in 18% of the patients. Despite high rates of cervical complications, in part linked to the peculiar setting of caustic injury, functional results remains satisfactory.
背景
通过一项使用右半结肠作为食管替代物的系统性政策，作者分析了这种移植用于消化性腐蚀性损伤后重建的可靠性。
方法
1995年至2005年，81例患者在全食管胃切除术后（n = 57）或因食管狭窄（n = 24）尝试进行右半结肠成形术。
结果
10例患者（12%）因血供不足无法使用右半结肠。此外，5例患者术后出现右半结肠移植物坏死。25例患者（31%）发生颈部瘘。胸廓入口开放与该并发症发生率较低相关（P = .04）。随访结束时，71例患者（88%）恢复经口进食。
结论
18%的患者尝试使用右半结肠作为食管替代物失败。尽管颈部并发症发生率较高，部分与腐蚀性损伤的特殊情况有关，但功能结果仍令人满意。
Zotero 插件