Kamath M V, Ellison R G, Rubin J W, Moore H V, Pai G P
Ann Thorac Surg. 1987 Mar;43(3):263-9. doi: 10.1016/s0003-4975(10)60609-1.
Mucocele of the bypassed esophagus is an unusual complication of esophageal replacement and has been described only in isolated references. This report is based on our experience with 6 patients in whom a mucocele developed following esophageal replacement. Esophageal replacement was performed on 37 patients over a 10-year period at the Medical College of Georgia Hospital. A symptomatic mucocele requiring excision developed in 3 patients with achalasia, 1 with congenital tracheoesophageal fistula, 1 with esophageal atresia, and 1 with inflammatory stricture. Conduits used included stomach (4), reversed gastric tube (1), and colon (1). Our experience indicates that conversion of a closed-loop esophagus into a symptomatic mucocele is more likely in the presence of functioning, chronically irritated mucosa. The clinical features were referable to the mucocele itself or respiratory embarrassment therefrom. Thoracic roentgenograms and computed tomographic scans were diagnostic in verifying the presence of the esophageal mucocele. All five mucoceles arose from squamous epithelium. One of 3 patients with achalasia in whom a mucocele developed following esophageal replacement had premalignant changes in the mucosa. Based on this experience, our treatment of choice is early, complete excision of the mucocele.
旷置食管黏液囊肿是食管置换术后一种罕见的并发症，仅有个别文献报道。本报告基于我们对6例食管置换术后发生黏液囊肿患者的经验。在佐治亚医学院医院10年期间对37例患者进行了食管置换。3例贲门失弛缓症、1例先天性气管食管瘘、1例食管闭锁和1例炎性狭窄患者发生了有症状的黏液囊肿，需要切除。使用的管道包括胃（4例）、翻转胃管（1例）和结肠（1例）。我们的经验表明，在存在功能正常、长期受刺激的黏膜时，闭合环食管更容易转变为有症状的黏液囊肿。临床特征与黏液囊肿本身或由此引起的呼吸窘迫有关。胸部X线片和计算机断层扫描对证实食管黏液囊肿的存在具有诊断价值。所有5个黏液囊肿均起源于鳞状上皮。3例贲门失弛缓症患者中有1例在食管置换术后发生黏液囊肿，其黏膜有癌前病变。基于这一经验，我们的首选治疗方法是早期彻底切除黏液囊肿。
