Vaysse P, Guitard J, Moscovici J, Cao-Van C, Juskiewenski S
Chir Pediatr. 1982 Mar-Apr;23(2):81-6.
The authors reported seven cases of megaesophagus by achalasia in children treated by transabdominal esophagomyotomy. There were five girls and two boys. Nor infantile neither familial forms were seen. Five children were cured clinically and radiologically at the third post operative month. Two failures were successfully treated by Thal's procedure. We concluded: (1) Infantile achalasia is not rare in recent literature; recurrent respiratory troubles and familial forms are frequent; prognosis is serious in this age groups. (2) Esophagus's width divided by thoracic vertebral corpus's height is a more objective criteria to appreciate megaesophagus's importance than esophagus's width alone. (3) Endoscopic biopsy is inadequate to detect tracheo bronchial remnants. (4) Appropriate treatment in children is surgical esophagomyotomy with fundoplication.
作者报告了7例经腹食管肌层切开术治疗的小儿贲门失弛缓症所致巨食管病例。其中5名女孩,2名男孩。未发现婴儿型及家族型。5名患儿在术后第3个月临床及影像学治愈。2例失败病例经塔尔手术成功治疗。我们得出结论:(1)在最近的文献中,婴儿型贲门失弛缓症并不罕见;反复呼吸道疾病和家族型很常见;该年龄组预后严重。(2)食管宽度除以胸椎椎体高度是比单纯食管宽度更客观的评估巨食管严重程度的标准。(3)内镜活检不足以检测气管支气管残余物。(4)儿童的适当治疗是手术食管肌层切开术加胃底折叠术。