Awsakulsutthi Surajit
Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
J Med Assoc Thai. 2010 Dec;93 Suppl 7:S303-6.
Seven esophageal reconstructions with interposition colon in severe suicide corrosive ingestion and Boehave's injury at Thammasat University Hospital were presented. Vascular enhancement (as called "supercharge") were done. Only one patient had micro-leakage at pharyngeal anastomosis with healed by conservative treatment and no late anastomotic stricture. The operation need more time and general surgeon skill but better comparison outcome.
Using supercharged interposition colon in adult esophageal reconstruction in corrosive and Boehave's injury was benefit in lower the incidence of anastomotic leakage and late anastomotic stricture. Just a longer operative time and vascular anatomizes skill were need.
本文介绍了泰国法政大学医院对7例因严重自杀性腐蚀性吞入及博赫夫氏损伤而进行结肠间置食管重建的病例。进行了血管强化(即“增压”)。只有1例患者在咽吻合处出现微小渗漏,经保守治疗愈合,未出现晚期吻合口狭窄。该手术需要更多时间和普通外科医生的技能,但效果更好。
在腐蚀性及博赫夫氏损伤的成人食管重建中使用增压结肠间置术有利于降低吻合口漏及晚期吻合口狭窄的发生率。只是需要更长的手术时间和血管解剖技能。