Di-Costanzo J, Cano N, Martin J, Noirclerc M
Br J Surg. 1981 Dec;68(12):879-81. doi: 10.1002/bjs.1800681214.
The surgical management of corrosive injuries of the stomach has not yet been clearly defined. This work analyses the results achieved with a surgical protocol included in a new therapeutic approach. This approach applied to 111 consecutive patients was based upon three points: (a) early fibroscopic examination, (b) protection of severe burns by total parenteral nutrition and (c) reparative surgery in the complete healing phase. The stomach was involved in 89 per cent of the 93 cases with proved gastrointestinal lesions; gastric lesions were isolated in 42 per cent of cases. The frequency of gastric involvement is partly related to the type of product ingested; the intensity of lesions is correlated with the quantity and the concentration of corrosive products. After a 3-month total parenteral nutrition period, reparative surgery can be performed without local complications in severe cases. Limited resections of the stomach must then be preferred when possible. In cases with total involvement bypass techniques can be carried out. Indications for early surgery are not yet well defined.
胃腐蚀性损伤的手术治疗方法尚未明确界定。本研究分析了一种新治疗方法中所包含的手术方案的治疗效果。该方法应用于111例连续患者，基于以下三点：（a）早期纤维内镜检查；（b）通过全胃肠外营养保护严重烧伤；（c）在完全愈合阶段进行修复手术。在93例经证实有胃肠道病变的病例中，胃受累的占89%；42%的病例胃病变为孤立性。胃受累的频率部分与摄入产品的类型有关；病变的严重程度与腐蚀性产品的数量和浓度相关。经过3个月的全胃肠外营养期后，严重病例可进行修复手术且无局部并发症。此时，应尽可能优先选择有限的胃切除术。在全胃受累的病例中，可采用旁路手术。早期手术的适应证尚未明确界定。
