Bresadola Vittorio, Terrosu Giovanni, Benzoni Enrico, Cherchi Vittorio, Adani Gian Luigi, Favero Alessandro, De Anna Dino
Bresadola Vittorio Department of Surgery, P. le S. M. della Misericordia 15 (Pad. Petracco), Udine, Italy.
Surg Laparosc Endosc Percutan Tech. 2008 Oct;18(5):498-501. doi: 10.1097/SLE.0b013e318173aa85.
The authors present 2 cases of esophageal perforation treated using a new 2-step approach, consisting of esophageal resection and delayed reconstruction of the digestive tract after laparoscopic preparation and transposition of the stomach. The method is characterized by the minimally invasive insertion of a gastric tube through the precardial esophageal stump for postoperative enteral nutrition, and by the use of a laparoscopic method in the reconstruction step for gastrolysis and transposition of the stomach. The benefits lie in the opportunity for enteral feeding preparatory to the reconstruction, with no need for any gastrostomy or jejunostomy, and with fewer complications and a better recovery after reconstruction surgery thanks to the use of a laparoscopic method instead of a laparotomy.
作者介绍了2例采用新的两步法治疗的食管穿孔病例，该方法包括食管切除以及在腹腔镜下准备和胃转位后延迟消化道重建。该方法的特点是通过贲门部食管残端微创插入胃管进行术后肠内营养，以及在重建步骤中使用腹腔镜方法进行胃松解和胃转位。其优点在于重建前有机会进行肠内喂养，无需任何胃造口术或空肠造口术，并且由于使用腹腔镜方法而非开腹手术，重建手术后并发症更少，恢复更好。
