Skvortsov M B, Pak E A, Shishkin V V, Gol'dberg O A, Bulygin V Ia
Khirurgiia (Mosk). 1991 Sep(9):40-5.
Operations were performed on 192 patients with reflux esophagitis, 23 of them had peptic stricture of the esophagus. Esophago-fundoplication was the main operation. Nissen's (106), Tupe (47), Belsi's (3), Dor's (5), and atypical methods were applied. Whenever indicated it was supplemented by crurorhaphy, SPV, pylorotomy, correction of the duodenal junction, etc. Resection of the esophagus (19) was performed with one-stage esophagoplasty by means of the stomach through a left thoracoabdominal approach (14), the whole stomach passed through the posterior mediastinum from an abdomino-cervical approach (2) and the whole stomach with Lewis' intrathoracic anastomosis (3). Distal gastric resection was carried out in 6 and other operations in 3 patients. The mortality was 1%. Reoperations were performed in 5 patients. The results were good in 81.2% of cases. The tactics is individualized according to the presence or absence of a stricture, its length, and localization of the upper border.
对192例反流性食管炎患者进行了手术，其中23例患有食管消化性狭窄。食管胃底折叠术是主要手术方式。采用了nissen术式（106例）、Tupe术式（47例）、Belsi术式（3例）、Dor术式（5例）以及非典型术式。如有必要，辅以膈肌缝合术、下腔静脉结扎术、幽门切开术、十二指肠连接部矫正术等。食管切除术（19例）采用经左胸腹联合切口利用胃进行一期食管成形术（14例），经腹颈联合切口将整个胃经后纵隔上提（2例）以及采用Lewis胸内吻合术的整个胃上提术（3例）。6例行远端胃切除术，3例进行了其他手术。死亡率为1%。5例患者进行了再次手术。81.2%的病例结果良好。根据是否存在狭窄、狭窄长度以及上缘定位进行个体化治疗策略。
