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[人工食管滑脱时间对新食管通道功能形成的影响]

[Impact of artificial esophagus slipped time upon the function formation of neoesophageal channel].

作者信息

Liang Jian-hui, Zhou Xing, Liang Xian-liang

机构信息

Department of Thoracic Surgery, Second Affiliated Hospital of Guangzhou Medical College, Institute of Guangzhou Cardiovascular Diseases, Guangzhou, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2009 Sep 22;89(35):2509-12.

Abstract

OBJECTIVE

To observe the impact of artificial esophagus slipped time upon the function formation of neoesophageal channel, explore the scope of secure control time and assess the treatment methods of neoesophageal stenosis.

METHODS

A total of 18 pigs in which artificial esophagus slipping at Month 1, 2, 3, 6 post-operation were observed with regards to complications, neoesophageal structures and functions and survival status of experimental animals.

RESULTS

Three pigs had a slip of artificial esophagus within a month post-operation and severe eating difficulties (Bown's Grade IV) because the neoesophagus had a severe narrowing (< 0.5 cm). All were dead shortly resulting from a failed treatment of esophageal dilation. Four pigs had a slip of artificial esophagus within 2 months post-operation. They all had dysphagia (Grade III-IV) as a result of moderate or severe neoesophageal stenosis (0.5 - 0.9 cm). Dysphagia was progressive. Repeated esophageal dilation was in vain. Three pigs were dead shortly and 1 pig achieved a long-term survival through a bare stent replacement therapy. Four pigs had a slip of artificial esophagus within 3 months post-operation. Dysphagia (Grade I-II) occurred as a result of mild or moderate neoesophageal stenosis (0.9 - 1.5 cm). Two pigs with moderate dysphagia achieved a long-term survival through a bare stent replacement therapy while another two were sacrificed. Seven had a slip of artificial esophagus at 3 months post-operation. The neoesophagus showed expansion and a relative narrowing (> 1.9 cm). Experimental animals had a mild difficulty in eating (Grade I), but it had an automatic relief. Experimental animals achieved a long-term survival and did not advance further.

CONCLUSION

Artificial esophagus (implant) stays in place for 2 - 3 months to form a functional esophageal channel. The longer an artificial esophagus is in place, a better channel of neoesophagus will form. Resetting a bare stent treatment of serious neoesophageal stenosis has significant therapeutic effects during this period. At 3 months post-operation, the slipping of artificial esophagus has little effects upon eating so that experimental animals may achieve a long-term survival.

摘要

目的

观察人工食管滑脱时间对新食管通道功能形成的影响,探讨安全控制时间范围并评估新食管狭窄的治疗方法。

方法

观察18只分别在术后1个月、2个月、3个月、6个月发生人工食管滑脱的猪的并发症、新食管结构与功能及实验动物的生存状况。

结果

3只猪在术后1个月内发生人工食管滑脱,因新食管严重狭窄(<0.5 cm)出现严重进食困难(Bown氏IV级),均因食管扩张治疗失败短期内死亡。4只猪在术后2个月内发生人工食管滑脱,因中度或重度新食管狭窄(0.5 - 0.9 cm)均出现吞咽困难(III - IV级),吞咽困难呈进行性,反复食管扩张无效,3只猪短期内死亡,1只猪通过裸支架置换治疗长期存活。4只猪在术后3个月内发生人工食管滑脱,因轻度或中度新食管狭窄(0.9 - 1.5 cm)出现吞咽困难(I - II级),2只中度吞咽困难的猪通过裸支架置换治疗长期存活,另2只被处死。7只猪在术后3个月后发生人工食管滑脱,新食管呈扩张状态且有相对狭窄(>1.9 cm),实验动物进食轻度困难(I级),但可自行缓解,实验动物长期存活且未进一步发展。

结论

人工食管(植入物)在位2 - 3个月可形成功能性食管通道,人工食管在位时间越长,新食管通道形成越好,在此期间对严重新食管狭窄行裸支架重置治疗有显著疗效。术后3个月人工食管滑脱对进食影响不大,实验动物可长期存活。

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