摘要
目的探讨在长段型食管闭锁治疗中，使用新的食管替代术式。方法从2005年10月至2009年6月使用了胸骨后顺行胃管代食管手术治疗6例长段型食管闭锁，其中5例Ⅰ型，1例ⅢA型。手术年龄最大1岁6个月，最小6个月。结果平均术后随访1年9个月，其中1例随访2年后失访，1例术后6个月反流窒息死亡。胸腔积液1例，吻合口漏5例，狭窄1例，均治愈。目前继续随访的4例患儿，能够正常吞咽和进食，营养和发育与同年龄小儿无差异，胃镜和造影检查未见明显的反流和食管炎，远期效果尚满意。结论顺行胃管代食管术是治疗长段型食管闭锁有效手术，手术创伤小，术后狭窄、反流等并发症发生率低，远期效果好。需要增加治疗例数，延长随访时间，改良技术，减少吻合口漏等并发症。
Objective To review the results of esophageal replacement for long-gap esophageal atresia. Methods Between October 2005 to June 2009,five patients with type Ⅰ esophageal atresia and one with typeⅢ A were treated with isoperistaltic gastric tube esophagoplasty via retrosternal route. The age of the patients ranged from 6 months to 1 year and 6 months. Results The average follow-up duration was 1 year and 9 months. One case was lost in follow-up two years post-operatively, One patient died of asphyxia from reflux six months after the operation. One case developed hydrothorax. There were 5 anastomotic leaks, 1anastomotic stricture. The complications were successfully managed. The long term result was satisfactory. Conclusions Isoperistaltic gastric tube esophagoplasty is a viable alternative for long-gap esophageal atresia. More cases, longer follow-up period, and technique improvement are required to reach a definite conclusion.
出处
《中华小儿外科杂志》
CSCD
北大核心
2010年第3期168-170,共3页
Chinese Journal of Pediatric Surgery
关键词
食管闭锁
食管成形术
Esophageal atresia
Esophagoplasty
