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结肠间置术治疗腐蚀性咽食管狭窄

Colon interposition for pharyngoesophageal postcorrosive strictures.

作者信息

Radovanović Nebojsa, Simić Aleksandar, Kotarac Milutin, Stojakov Dejan, Sabljak Predrag, Skrobić Ognjan, Pesko Predrag

机构信息

Department of Foregut Surgery, First Surgical University Hospital, Institute for Digestive Diseases, Clinical Center of Serbia, Belgrade, Koste Todorovića 6, 11 000 Belgrade.

出版信息

Hepatogastroenterology. 2009 Jan-Feb;56(89):139-43.

Abstract

BACKGROUND/AIM: Aim of this paper is to report a 40 years experience in performing colon interposition for pharyngoesophageal caustic injury.

METHODOLOGY

In the period between 1965 and 2005, 83 colon interpositions were performed due to the pharyngeal and high esopahageal injuries. Patients were classified according to the uppermost level of stricture in 3 groups: supraglotic, hypopharyngeal and esophageal ostium. In most of the patients (89.1%) an extrapleural retrosternal by-pass colon interposition was performed, while in the remaining 10.9% a colon interposition with esophagectomy had to be done. Long-term follow-up results were obtained in the period between one and up to 30 years.

RESULTS

Early postoperative complications occurred in 16.8% of patients, among which anastomotic leakage was the most common. Overall intrahospital mortality rate was 6%, while late postoperative complications were present in 14.4% of patients. Long-term follow-up was obtained in 84.2% of patients, with excellent functional results being present in 86.7% of them.

CONCLUSION

Colon graft is an excellent esophageal substitute for patients with pharyngoesophageal corrosive strictures, and used by experienced surgical team it provides low postoperative morbidity as well as mortality rate, and a long time good and functional quality of life.

摘要

背景/目的:本文旨在报告40年来进行结肠代食管术治疗咽食管腐蚀性损伤的经验。

方法

在1965年至2005年期间,因咽和高位食管损伤进行了83例结肠代食管术。根据狭窄的最高水平将患者分为3组:声门上型、下咽型和食管入口型。大多数患者(89.1%)采用经胸骨后胸膜外结肠旁路代食管术,其余10.9%的患者则需行结肠代食管术并同时行食管切除术。随访时间为1至30年。

结果

16.8%的患者术后早期出现并发症,其中吻合口漏最为常见。总体院内死亡率为6%,14.4%的患者出现术后晚期并发症。84.2%的患者获得了长期随访,其中86.7%的患者功能恢复良好。

结论

结肠移植是治疗咽食管腐蚀性狭窄患者的一种优良的食管替代物,由经验丰富的手术团队操作,术后发病率和死亡率较低,并能长期维持良好的生活质量和功能。

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