Dickson J A
Paediatric Surgical Unit, Children's Hospital, Sheffield, UK.
Pediatr Surg Int. 1996 Apr;11(4):224-6. doi: 10.1007/BF00178422.
Twenty-three interpleural (Waterston) colon replacements of the esophagus are reported, 21 for esophageal atresia and 2 for corrosive strictures. Twenty patients are alive with an intact replacement; 17 are swallowing well and 3 have some dysphagia. Two grafts were converted to reverse gastric tubes, 1 for venous infarction and the other because of difficult vascular anatomy. One child died from disseminated intravascular coagulation following gastroenteritis shortly after successful completion of the interposition. Technical details of the operation are described. The need for replacement has been much less in recent years because of improved surgical techniques for esophageal atresia, particularly elective ventilation and the upper pouch flap operation. Recognition that corrosive and reflux strictures, if a dilatable channel can be maintained, will improve if dilatation is persevered with for 2 years may avoid the need for replacement.
本文报告了23例经胸膜腔（沃特斯顿法）行食管结肠替代术的病例，其中21例为食管闭锁，2例为腐蚀性狭窄。20例患者存活且替代物完整；17例吞咽良好，3例有轻度吞咽困难。2例移植物改为逆胃管，1例因静脉梗死，另1例因血管解剖困难。1例患儿在成功完成肠间置术后不久，因胃肠炎并发弥散性血管内凝血死亡。文中描述了手术的技术细节。近年来，由于食管闭锁手术技术的改进，尤其是选择性通气和上袋瓣手术，食管替代术的需求已大大减少。认识到如果能维持可扩张通道，对于腐蚀性和反流性狭窄，坚持扩张2年病情可能改善，这可能避免替代术的需要。
