Kennedy A P, Cameron B H, McGill C W
Department of General Surgery, Geisinger Medical Center, Danville, PA 17822-2111, USA.
J Pediatr Surg. 1995 Aug;30(8):1242-5. doi: 10.1016/0022-3468(95)90033-0.
Severe caustic injury with stricture may require esophageal reconstruction. The available methods of esophageal substitution do not satisfactorily replace the peristaltic and antireflux properties of the native esophagus. The authors report the results of two children treated with colon patch esophagoplasty and preservation of the injured esophagus. Both were 2 years of age when they accidently swallowed lye. Long esophageal strictures developed, which were resistant to repeated dilatation. Eleven and 13 months after the injury, the patients underwent colon patch esophagoplasty. A segment of the left colon was tailored to the length and shape of the opened stricture and was anastomosed side-to-side to the esophagotomy. One child later had a short recurrent stricture and diverticulum, which required revision of the distal end of the anastomosis. Follow-up endoscopic examination has shown healing of the esophagus and resolution of the strictures; both children are eating normally 3 years after surgery, without symptoms of gastroesophageal reflux. Colon patch esophagoplasty is an alternative to esophageal replacement for long caustic esophageal strictures. Its advantage is preservation of the peristaltic and antireflux mechanisms of the conserved esophagus.
伴有狭窄的严重腐蚀性损伤可能需要进行食管重建。现有的食管替代方法无法令人满意地替代天然食管的蠕动和抗反流特性。作者报告了两例接受结肠补片食管成形术并保留受损食管的儿童的治疗结果。两名儿童均在2岁时意外吞服了碱液。随后出现了长段食管狭窄，对反复扩张治疗无效。受伤11个月和13个月后，这两名患者接受了结肠补片食管成形术。将一段左结肠修剪成与开放狭窄部位的长度和形状相匹配，然后与食管切开处进行侧侧吻合。其中一名儿童后来出现了短段复发性狭窄和憩室，需要对吻合口远端进行修复。随访内镜检查显示食管愈合且狭窄消失；两名儿童术后3年饮食正常，无胃食管反流症状。结肠补片食管成形术是治疗长段腐蚀性食管狭窄的一种食管替代方法。其优点是保留了食管的蠕动和抗反流机制。
