一种简单的斜形吻合技术可预防食管闭锁一期修复后狭窄的形成。
A simple technique of oblique anastomosis can prevent stricture formation in primary repair of esophageal atresia.
机构信息
Pediatric Surgical Unit, Department of Mother and Child Care, University of Palermo, Palermo, Italy.
出版信息
J Pediatr Surg. 2012 Sep;47(9):1767-71. doi: 10.1016/j.jpedsurg.2012.04.021.
BACKGROUND
Anastomotic stricture is an important problem after esophageal atresia (EA) repair. This study evaluates a technique of oblique esophageal anastomosis without use of a flap in order to prevent stricture formation.
METHODS
Medical records of 16 patients (14 with EA type III and 2 with EA type IV Ladd-Gross classification) who underwent primary repair of EA at birth without anastomotic tension were reviewed, evaluating long-term follow-up results. All patients were studied with esophageal contrast study, pH-multichannel intraluminal impedance, and endoscopy. The incidence of complications and their management were analysed.
RESULTS
Contrast esophagogram and esophagoscopy always showed regular patency of the suture line.
CONCLUSIONS
Our technique of oblique anastomosis is simple, safe, and effective in preventing stricture formation even in the long-term follow-up.
背景
食管闭锁（EA）修复后吻合口狭窄是一个重要问题。本研究评估了一种不使用皮瓣的斜形食管吻合术技术，以防止狭窄形成。
方法
回顾了 16 例（EA Ⅲ型 14 例，Ladd-Gross 分类 EA Ⅳ型 2 例）出生时无吻合张力的 EA 患者行一期修复的病历，评估长期随访结果。所有患者均行食管造影、pH 多通道腔内阻抗和内镜检查。分析并发症的发生率及其处理方法。
结果
对比食管造影和食管镜检查始终显示缝线通畅。
结论
我们的斜形吻合技术简单、安全、有效，即使在长期随访中也能有效预防狭窄形成。
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