胃管食管成形术用于小儿食管置换

Gastric tube esophagoplasty for pediatric esophageal replacement.

作者信息

Elfiky Mahmoud M A, El Tagy Gamal, Mohamed Wissam, Abdel Azim Osama, Elfiky Mohamed A

机构信息

Pediatric Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.

出版信息

J Pediatr Surg. 2017 Apr;52(4):657-662. doi: 10.1016/j.jpedsurg.2016.12.012. Epub 2016 Dec 24.

DOI:10.1016/j.jpedsurg.2016.12.012

PMID:28063680

Abstract

BACKGROUND

Esophageal replacement in children is indicated in cases of esophageal atresia with or without fistula, in case of long gap esophageal atresia or failed primary repair. Intractable post corrosive esophageal stricture is considered also a major indication for replacement.

METHODS

This is a cohort retrospective study of esophageal replacement cases by gastric tube carried out at the pediatric surgery department at Cairo University between 2011 and 2015. We reported 50 patients (30 boys and 20 girls); the ages ranged from 7months to 9years. Esophageal atresia cases were 27 while caustic esophageal stricture cases were 23. Isoperistaltic gastric tube technique was done in 45 patients while antiperistaltic (reversed) gastric tube technique was done in 5 cases. Retrosternal route was chosen in 38 patients while transhiatal route was chosen in 12 patients.

RESULTS

Leakage and stricture were the most common complications. We had 5 cases of mortality, which were caused mainly by chest related complications. We had excellent to good results during long term follow up in terms of weight gain, swallowing pattern, quality of life, and overall satisfaction CONCLUSION: Gastric tube is a satisfactory surgical method for esophageal replacement in children.

LEVEL OF EVIDENCE

III.

摘要

背景

儿童食管置换适用于伴有或不伴有瘘管的食管闭锁病例、长段食管闭锁病例或初次修复失败的情况。顽固性腐蚀性食管狭窄也被视为置换的主要指征。

方法

这是一项对2011年至2015年在开罗大学儿科外科进行的胃管食管置换病例的队列回顾性研究。我们报告了50例患者（30名男孩和20名女孩）；年龄范围为7个月至9岁。食管闭锁病例27例，腐蚀性食管狭窄病例23例。45例患者采用顺蠕动胃管技术，5例采用逆蠕动（翻转）胃管技术。38例患者选择胸骨后途径，12例患者选择经裂孔途径。