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[胸腹段食管切除术后的脊髓前动脉综合征。一种罕见的并发症]

[Anterior spinal artery syndrome after thoraco-abdominal esophagus resection. A rare complication].

作者信息

Boedeker H, Schmidt J, Zirngibl H

机构信息

Klinik und Poliklinik für Chirurgie, Universität Regensburg.

出版信息

Chirurg. 1997 Sep;68(9):902-5. doi: 10.1007/s001040050292.

Abstract

We report a case of postoperative paraplegia resembling an anterior spinal artery syndrome after curative esophagectomy in a patient with carcinoma of esophagus and clinical stage III (UICC). Neurologic deficit was characterized by loss of sensibility at the level of T12/L1 together with paraparesis of both lower extremities. Furthermore, dissociated sensorimotor depletion at C6/C7 (right-sided) and at T5 (left-sided) was noted. This severe complication was most probably caused by peeling of an arteriosclerotic plaque of the thoracic aorta due to preexisting advanced arteriosclerosis, leading to a partial occlusion of the great radicular artery of Adamkiewicz. Even though anterior spinal artery syndrome is a well-known problem in the operative management of thoracic aortic aneurysms, this complication has not previously been reported after esophagectomy.

摘要

我们报告一例食管癌患者(临床分期为III期,UICC)在根治性食管切除术后出现类似脊髓前动脉综合征的术后截瘫病例。神经功能缺损的特征为T12/L1水平感觉丧失以及双下肢轻瘫。此外,还发现C6/C7(右侧)和T5(左侧)存在分离性感觉运动缺失。这种严重并发症很可能是由于先前存在的严重动脉硬化导致胸主动脉粥样硬化斑块剥离,进而致使Adamkiewicz大根动脉部分闭塞。尽管脊髓前动脉综合征在胸主动脉瘤手术治疗中是一个众所周知的问题,但此前食管切除术后尚未有此并发症的报道。

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