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[食管憩室(不包括环咽肌憩室)]

[Esophageal diverticula (excluding cricopharyngeal diverticula)].

作者信息

Gutschow C A, Schmidt H

机构信息

Klinik für Viszeral- und Transplantationschirurgie, Universitätsspital Zürich, Rämistraße 100, 8091, Zürich, Schweiz.

出版信息

Chirurg. 2018 May;89(5):401-412. doi: 10.1007/s00104-017-0588-8.

Abstract

Diverticula of the middle and lower third of the esophagus are commonly associated with esophageal motility disorders. The increase of intraluminal pressure leads to an outpouching of the mucosal and submucosal layers through the esophageal muscle coat. These pouches are also called false diverticula, because they only consist of the mucosal and submucosal esophageal layers. In contrast, the more rarely encountered true diverticula that retain the complete esophageal wall are generally associated with periesophageal granulomatous lymph node disease. Treatment of both true and false diverticula is generally indicated in symptomatic patients; however, even state of the art minimally invasive surgery is accompanied by considerable perioperative morbidity and should only be performed in carefully selected patients. This aim of this article is to summarize the available scientific evidence and to provide the reader with an updated guide to best clinical practice in the treatment of esophageal diverticula.

摘要

食管中下段憩室通常与食管动力障碍有关。管腔内压力增加导致黏膜层和黏膜下层通过食管肌层向外膨出。这些囊袋也被称为假性憩室,因为它们仅由食管的黏膜层和黏膜下层组成。相比之下,较少见的真性憩室保留了完整的食管壁,通常与食管周围肉芽肿性淋巴结病有关。有症状的患者一般都需要对真性和假性憩室进行治疗;然而,即使是最先进的微创手术也伴随着相当高的围手术期发病率,并且仅应在精心挑选的患者中进行。本文的目的是总结现有的科学证据,并为读者提供一份关于食管憩室治疗最佳临床实践的最新指南。

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