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胸腔镜辅助下食管切除术治疗腐蚀性食管狭窄

Thoracolaparoscopic-Assisted Esophagectomy for Corrosive-Induced Esophageal Stricture.

作者信息

Nayar Raghav, Varshney Vaibhav, Suman Sunita, Soni Subhash, Kumar Naveen

机构信息

Surgical Gastroenterology, All India Institute of Medical Sciences, Jodhpur, IND.

Medical Gastroenterology, Mathura Das Mathur Hospital, Jodhpur, IND.

出版信息

Cureus. 2020 May 1;12(5):e7909. doi: 10.7759/cureus.7909.

Abstract

Corrosive-induced stricture of the digestive tract is a dreaded complication following corrosive ingestion. When surgical reconstruction is needed, esophagectomy helps to avoid the long-term complications related to leaving behind the scarred native esophagus. We tried to ascertain the feasibility and safety of a thoracolaparoscopic-assisted esophagectomy in such a setting. A 32-year-old male presented with corrosive-induced esophageal stricture that lead to progressive dysphagia not amenable for endoscopic dilatation. Thoracoscopic approach was used for mobilization of the scarred esophagus under vision. Laparoscopic approach was used in mobilizing the stomach and creating a conduit. Esophagogastric anastomosis was performed in the neck. The patient had an uneventful recovery postoperatively and was discharged after six days on a semisolid diet. Thoracolaparoscopic-assisted esophagectomy can be safely performed for corrosive strictures of the esophagus. Besides improving the ease of performing the procedure, it also helps mitigate the morbidity associated with conventional open surgery in such cases.

摘要

腐蚀性物质导致的消化道狭窄是腐蚀性物质摄入后令人恐惧的并发症。当需要进行手术重建时,食管切除术有助于避免因保留瘢痕化的原生食管而产生的长期并发症。我们试图确定在这种情况下胸腔镜辅助腹腔镜食管切除术的可行性和安全性。一名32岁男性因腐蚀性物质导致食管狭窄,进而出现进行性吞咽困难,无法通过内镜扩张治疗。采用胸腔镜方法在直视下游离瘢痕化食管。采用腹腔镜方法游离胃并构建管道。在颈部进行食管胃吻合术。患者术后恢复顺利,术后6天进食半固体食物后出院。胸腔镜辅助腹腔镜食管切除术可安全地用于治疗食管腐蚀性狭窄。除了提高手术操作的简便性外,它还有助于减轻此类病例中传统开放手术相关的发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2a/7263410/df0d340020c8/cureus-0012-00000007909-i01.jpg

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