Lu Z C, Chen L G, Zhang Y Y
Department of Digestive Tumor, Endoscopicunit Zhejiang Provincial Cancer Hospital, Hangzhou.
Zhonghua Zhong Liu Za Zhi. 1994 Nov;16(6):451-3.
Anastomotic stricture has become a common complication following surgical treatment of upper gastrointestinal cancers. A technique was devised to alleviate the stricture with Nd. YAG laser beam under endoscopy. The laser beam was applied at 3-4 different points near the anastomotic stoma. The thermal effect of the beam would cut the scar tissues in and underneath the mucosa, leading to dilatation of the stoma. A total of 48 patients with cancer of the esophagus (n = 21), gastric cardia (n = 20), body of stomach (n = 6) and gastric stump (n = 1) with postoperative anastomotic stricture was so treated. According to the degree of dilatation, the result of treatment upon longterm follow-up was good (the anastomotic stoma was enlarged more than 6 mm) in 41 (85.4%), fair (the stoma enlarged 4-5 mm) in 5 (10.4%) and poor in the remaining 2. Due precautions should be made to avoid bleeding and perforation.
吻合口狭窄已成为上消化道癌手术治疗后的常见并发症。我们设计了一种在内镜下用钕钇铝石榴石激光束缓解狭窄的技术。激光束在吻合口附近的3 - 4个不同点进行照射。激光束的热效应会切割黏膜内及黏膜下的瘢痕组织,从而使吻合口扩张。共有48例食管癌(n = 21)、贲门癌(n = 20)、胃体癌(n = 6)和残胃癌(n = 1)术后吻合口狭窄的患者接受了该治疗。根据扩张程度,长期随访的治疗结果为:良好(吻合口扩大超过6 mm)41例(85.4%),尚可(吻合口扩大4 - 5 mm)5例(10.4%),其余2例效果较差。应注意预防出血和穿孔。