Kerr W F
Thorax. 1968 Mar;23(2):204-9. doi: 10.1136/thx.23.2.204.
In the treatment of instrumental perforation of the obstructed thoracic oesophagus, relief of obstruction is one of the prerequisites of success. In some cases it is better to resect both the perforation and the original lesion rather than to rely on repair and drainage. The salient features of 19 cases of emergency oesophagectomy collected from the literature have been tabulated, and three new examples are here reported. The results are encouraging. The operation usually performed for malignant cases is a one-stage oesophagogastrectomy with oesophagogastrostomy; a two-stage procedure is recommended for benign lower-end strictures. The lacerated oesophagus and the stricture are resected at the emergency operation, and the fundus of the stomach, advanced into the chest, is anastomosed to the oesophagus. The whole of the stomach is thereby preserved for the elective reconstruction which constitutes the second stage.
在治疗梗阻性胸段食管器械穿孔时，解除梗阻是成功的前提条件之一。在某些情况下，切除穿孔部位和原发病变比单纯依靠修补和引流更好。现将从文献中收集的19例急诊食管切除术的显著特征制成表格，并报告3例新病例。结果令人鼓舞。通常针对恶性病例施行的手术是一期食管胃切除术并进行食管胃吻合术；对于良性下端狭窄，建议采用两期手术。在急诊手术中切除撕裂的食管和狭窄部位，将胃底上提到胸腔与食管吻合。这样可保留整个胃用于择期重建，即构成第二阶段手术。
