Bremner C G
J R Coll Surg Edinb. 1989 Dec;34(6):297-301.
Benign reflux strictures most commonly result from gastro-oesophageal reflux but other causes must be excluded. Ambulatory pH monitoring is useful to confirm and quantitate the severity of reflux. Reflux strictures can be managed by dilatation and vigorous continued antireflux treatment but surgery offers a safe and more effective means of correcting the physiological dysfunction of the sphincter. Healthy patients should, therefore, be offered a permanent cure by surgery and conservative measures should be reserved for patients who are elderly, obese or unfit for surgical management. Before starting surgical treatment a full investigation is mandatory. Radiological, endoscopic, histological and cytological studies, pH monitoring, motility evaluation of the motor power of the oesophagus and sphincter and an assessment of gastric emptying are all necessary investigations for a complete evaluation of the dysfunction and effective surgical planning.
良性反流性狭窄最常见于胃食管反流，但必须排除其他病因。动态pH监测有助于确诊反流并量化其严重程度。反流性狭窄可通过扩张及持续积极的抗反流治疗进行处理，但手术是纠正括约肌生理功能障碍更安全、有效的方法。因此，健康患者应接受手术以获得根治，而保守治疗应仅用于老年、肥胖或不宜手术的患者。在开始手术治疗前，必须进行全面检查。放射学、内镜、组织学及细胞学检查、pH监测、食管和括约肌动力评估以及胃排空评估，都是全面评估功能障碍及有效制定手术方案所必需的检查。
