Burdick J S, Venu R P, Hogan W J
Medical College of Wisconsin, Milwaukee.
Gastrointest Endosc. 1993 Sep-Oct;39(5):616-9. doi: 10.1016/s0016-5107(93)70210-2.
A symptomatic lower esophageal ring generally responds to standard bougienage therapy. However, a subset of patients with a lower esophageal ring defy dilation therapy. We have evaluated the efficacy of electrocautery incision of "defiant" lower esophageal rings, the data of which forms the basis of this report. Seven of 75 patients with a lower esophageal ring failed to respond to conventional esophageal dilation. All seven patients underwent electrocautery incision of a "defiant" lower esophageal ring with alleviation of dysphagia. One patient had recurrence of dysphagia that occurred 6 months after initial electrocautery incision. No major complication occurred, although one patient had transient chest pain. Subsequently, all patients have remained without symptoms at a mean follow-up of 36 months. Electrocautery incision of "defiant" lower esophageal ring is efficacious, safe, and results in long-term relief of dysphagia.
有症状的下食管环通常对标准的探条扩张疗法有反应。然而，一部分下食管环患者对扩张疗法无效。我们评估了对“难治性”下食管环进行电灼切开术的疗效，本报告的数据即以此为基础。75名下食管环患者中有7名对传统食管扩张术无反应。所有7名患者均接受了“难治性”下食管环的电灼切开术，吞咽困难症状得到缓解。1名患者在初次电灼切开术后6个月出现吞咽困难复发。尽管有1名患者出现短暂胸痛，但未发生重大并发症。随后，所有患者在平均36个月的随访中均无症状。对“难治性”下食管环进行电灼切开术是有效、安全的，且能长期缓解吞咽困难。
