Matsuki Atsushi, Kanda Tatsuo, Kosugi Shin-ichi, Suzuki Tsutomu, Hatakeyama Katsuyoshi
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-754 Asahimachidori, Niigata, 951-8510, Japan.
Surg Today. 2009;39(3):261-4. doi: 10.1007/s00595-008-3834-3. Epub 2009 Mar 12.
Corrosive esophagitis, caused by swallowing corrosive acid or alkali, results in cicatricial stricture of the esophagus. The stricture is often accompanied by pyloric stenosis because strong acids act synergistically with gastric juice. Resection of both the esophagus and stomach is usually necessary, and the colon or jejunum is used as an esophageal substitute. We describe how we successfully treated corrosive esophagitis associated with pyloric stenosis, by performing gastric tube interposition for the esophageal reconstruction. After resecting the injured distal part of the stomach, we pulled the pedunculated gastric tube up to the cervix after anastomosis to the jejunal limb in a Roux-en-Y fashion. This reconstruction procedure prevented excessive organ sacrifice and was minimally invasive. Thus, esophageal reconstruction by interposition using a pedunculated gastric tube can be used effectively to treat corrosive esophagitis associated with pyloric stenosis.
腐蚀性食管炎由吞服腐蚀性酸或碱引起,会导致食管瘢痕性狭窄。这种狭窄常伴有幽门狭窄,因为强酸与胃液起协同作用。通常需要同时切除食管和胃,并用结肠或空肠作为食管替代物。我们描述了如何通过行胃管置入术进行食管重建,成功治疗与幽门狭窄相关的腐蚀性食管炎。切除受损的胃远端部分后,我们将带蒂胃管以Roux-en-Y方式与空肠袢吻合,然后将其向上拉至颈部。这种重建手术避免了过多的器官切除,且创伤极小。因此,使用带蒂胃管置入进行食管重建可有效治疗与幽门狭窄相关的腐蚀性食管炎。