Kotsis L, Krisár Z
Nagyváradi Megyei Kórház, Sebészeti Osztály, Románia.
Orv Hetil. 1990 Jun 10;131(23):1241-6.
Late aspects of adaptation were studied on the basis of 135 esophagoplasty by means of isoperistaltic (except of 7 anisoperistaltic) transverse colon for corrosive strictures. Histochemically, the augmentation of neutral mucopolysaccharide, which increases mucosal resistance--was observed on the surface and in Lieberkühn glands of colonic mucosa. Mucosal absorption remains unmodified. Transit time is considerable longer, but without functional consequences. Radiokinematographically, characteristic, coordinated, multihaustral, propulsive movements of transverse colon were present, playing a secondary, but active role in the swallowing mechanism. In the authors opinion, the marked differences between the iso- and anisoperistaltic interposition modality, in point of view of gastro-colic reflux, is explained by these unmodified, more independent, motor activity of the bowel wall. Good long-term functional results were present in 92% of patients. In management of corrosive strictures, isoperistaltic transverse colon may be considered the graft of choice, both technically and functionally.
基于135例采用等蠕动(7例为异蠕动)横结肠修复腐蚀性食管狭窄的食管成形术,对适应后期的情况进行了研究。组织化学研究发现,结肠黏膜表面及利伯kühn腺体内中性黏多糖增加,这增强了黏膜抵抗力。黏膜吸收功能未改变。传输时间显著延长,但无功能影响。放射动力学检查显示,横结肠呈现出特征性、协调性、多袋状的推进运动,在吞咽机制中起次要但积极的作用。作者认为,从胃结肠反流的角度来看,等蠕动和异蠕动间置方式存在显著差异,这是由肠壁未改变的、更独立的运动活性所解释的。92%的患者获得了良好的长期功能结果。在腐蚀性食管狭窄的治疗中,无论是从技术还是功能方面考虑,等蠕动横结肠都可被视为首选的移植材料。