Ellis F H, Gibb S P
Department of Thoracic and Cardiovascular Surgery, Lahey Clinic Medical Center, Burlington, MA 01805.
J Thorac Cardiovasc Surg. 1990 Feb;99(2):192-7; discussion 197-9.
We report the cases of 35 patients with complex benign esophageal disease who required radical surgical reconstruction. These patients had undergone 63 previous esophageal operations. Twenty-seven patients required esophagogastrectomy, four had esophageal exclusion before colon interposition, two had cardioplasty, and two without stricture did not require resection. Reconstruction was achieved by esophagogastrostomy in six patients, colon interposition in eight, and acid suppression and alkaline diversion in 21. One patient died of pneumonia 2 weeks after esophagogastrostomy. The overall rate of postoperative improvement was 70%, but the condition of 86% of patients was improved after the acid-suppression and alkaline-diversion procedure, which is the reconstructive procedure we prefer in properly selected patients with complex benign esophageal disease.
我们报告了35例需要进行根治性手术重建的复杂良性食管疾病患者的病例。这些患者此前共接受过63次食管手术。27例患者需要进行食管胃切除术，4例在结肠间置术前进行了食管旷置术，2例进行了贲门成形术，2例无狭窄则无需切除。6例患者通过食管胃吻合术进行重建，8例通过结肠间置术重建，21例通过抑酸和碱性转流术重建。1例患者在食管胃吻合术后2周死于肺炎。术后总体改善率为70%，但在抑酸和碱性转流术后，86%患者的病情得到改善，这是我们在适当选择的复杂良性食管疾病患者中更倾向采用的重建手术。
