Fujita H, Inoue Y, Kakegawa T, Yamana H, Tai Y, Hirano M
First Department of Surgery, Kurume University School of Medicine, Japan.
Jpn J Surg. 1991 Nov;21(6):682-6. doi: 10.1007/BF02471055.
The management of corrosive strictures of the esophagus involving the pharynx and/or larynx continues to be a challenge to surgeons. This paper presents a case of a corrosive stricture extending from the hypopharynx to the cervical esophagus associated with complete obstruction of the larynx, which was successfully treated by pharyngoesophageal bypass using a free jejunal graft. Postoperative recovery was smooth without any complications, and swallowing was restored. Three months after the bypass operation, the patient underwent laryngoplasty. Although aspiration occurred immediately after the laryngoplasty, six months later she was again able to tolerate the oral intake of semisolid food without any need for supplementary nutritional support. Reconstruction of a short segment of the pharyngoesophageal stricture by a free jejunal graft restores almost normal swallowing provided that dilatation of the lower esophagus is achieved.
涉及咽和/或喉的食管腐蚀性狭窄的治疗仍然是外科医生面临的一项挑战。本文介绍了一例腐蚀性狭窄从下咽延伸至颈段食管并伴有喉完全梗阻的病例，该病例通过使用游离空肠移植物进行咽食管旁路手术成功治疗。术后恢复顺利，无任何并发症，吞咽功能得以恢复。旁路手术后三个月，患者接受了喉成形术。尽管喉成形术后立即出现了误吸，但六个月后她再次能够耐受口服半固体食物，无需任何补充营养支持。只要实现了食管下段的扩张，通过游离空肠移植物重建短段咽食管狭窄几乎可以恢复正常吞咽。
