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[小儿腐蚀性食管狭窄胃管食管成形术的初步研究]

[Preliminary study on gastric tube esophagoplasty for corrosive strictures of the esophagus in children].

作者信息

Liu Wei, Liang Jian-hua, Zeng Jia-hang, Tang Jue

机构信息

Department of Thoracic Surgery, Guangzhou Women and Children's Medical Center, Guangzhou, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Sep;15(9):954-6.

Abstract

OBJECTIVE

To study the clinical value of gastric tube esophagoplasty for complicated corrosive stricture of the esophagus in children.

METHODS

A retrospective analysis was performed to study 7 patients with complicated corrosive stricture of the esophagus who were treated with gastric tube esophagoplasty via retrosternal route between March 2010 and October 2011.

RESULTS

Three patients had a stricture longer than 2.5 cm, and 4 patients had more than one stricture. All the operations went well. The average time for mechanical ventilation postoperatively was 6 hours. No patients showed insufficient ventilation after withdraw of ventilator. There was 1 patient developed anastomotic leak which was healed a week later. One patient had anastomotic leak with pyloric obstruction, and the leak was healed 3 weeks after intraoperative placement of duodenal feeding tube and pyloric obstruction became patent 4 weeks later. There were 2 patients developed anastomotic stricture and they resumed normal diet after balloon dilatation. The average follow-up duration was 10.5 months. The quality of life was improved and no other complications were found.

CONCLUSION

Gastric tube esophagoplasty is a effective alternative for complicated corrosive stricture of the esophagus and the short-term outcomes are favorable.

摘要

目的

探讨胃管代食管术治疗小儿复杂性腐蚀性食管狭窄的临床价值。

方法

回顾性分析2010年3月至2011年10月间采用经胸骨后途径行胃管代食管术治疗的7例小儿复杂性腐蚀性食管狭窄患者的临床资料。

结果

3例食管狭窄长度超过2.5 cm,4例存在多处狭窄。所有手术均顺利完成。术后平均机械通气时间为6小时。脱机后无患者出现通气不足。1例发生吻合口漏,1周后愈合。1例吻合口漏合并幽门梗阻,术中置入十二指肠营养管后3周漏口愈合,4周后幽门梗阻解除。2例发生吻合口狭窄,经球囊扩张后恢复正常饮食。平均随访时间为10.5个月。生活质量得到改善,未发现其他并发症。

结论

胃管代食管术是治疗小儿复杂性腐蚀性食管狭窄的有效方法,近期效果良好。

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