Lee M E, Overholt R H
Ann Thorac Surg. 1977 Jan;23:68-72. doi: 10.1016/s0003-4975(10)64072-6.
This is a report of recurrent multiple leiomyomas of the esophagus treated initially by enucleation and subsequently by myectomy of the involved portion of the esophagus to prevent further recurrence. Experimental studies support the clinical observation that the esophagus will function as a conduit for food in the absence of an orderly progression of peristalsis. Preservation of hilar truncal vagus nerve function must be accomplished if normal lower esophageal sphincter function is to be maintained. We believe this is the first report of deliberate esophageal myectomy in a human patient with manometric and cineradiographic documentation of satisfactory function postoperatively. Limited myectomy may be considered, as circumstances require, in the treatment of multiple esophageal leiomyomas, although enucleation remains the treatment of choice.
本文报道了一例复发性食管多发性平滑肌瘤的病例,最初采用摘除术治疗,随后为防止进一步复发,对食管受累部分进行了肌层切除术。实验研究支持了以下临床观察结果:在没有正常蠕动顺序进展的情况下,食管仍可作为食物的通道。如果要维持正常的食管下括约肌功能,必须保留肺门主干迷走神经功能。我们认为,这是第一例对人类患者进行选择性食管肌层切除术的报告,术后通过测压和电影造影记录了满意的功能。尽管摘除术仍是首选治疗方法,但在治疗多发性食管平滑肌瘤时,可根据具体情况考虑进行有限的肌层切除术。