摘要
目的探讨先天性食管狭窄的诊断及治疗方式。方法回顾性分析首都医科大学附属北京儿童医院2015年6月至2018年12月收治的4例先天性食管狭窄患儿的临床资料。4例患儿均为男性,入院年龄分别为5岁1个月、4岁2个月、10个月和3岁7个月。结果1例入院后诊断为贲门失迟缓症,在腹腔镜食管肌层切开过程中发现食管下段软骨异位,切除异位软骨后保留完整食管黏膜,随访1年进食顺利。1例先天性食管闭锁合并食管下段狭窄,多次影像学检查漏诊食管下段狭窄,胸腔镜下完成狭窄段切除再吻合,随访8个月进食顺利。1例球囊扩张食管4次,随访4个月进食顺利。1例先天性食管狭窄合并十二指肠梗阻,腹腔镜解除十二指肠梗阻7个月后行胸腔镜食管切除再吻合手术,随访2个月进食顺利。结论先天性食管狭窄常合并其它消化道畸形,容易漏诊,其治疗方式尚存在争议,腔镜手术具有较高可行性。
Objective To explore the diagnosis and treatment of congenital esophageal stenosis(CES).Methods Retrospective analysis was conducted for the clinical data of 4 CES boys from June 2015 to December 2018.The ages of admission were 61,50,10 and 43 months respectively.Results Case 1 was diagnosed as achalasia cardia after admission.During laparoscopic esophageal myotomy,ectopic cartilage in lower esophagus was removed with intact esophageal mucosa.Case 2 had CES associated with esophageal atresia.Lower esophageal stenosis was missed for several times.And thoracoscopic stenosis resection and re-anastomosis were performed.Case 3 had stenosis of lower esophagus and balloon-dilate was performed for 4 times.Case 4 had CES with multiple duodenal obstructions and laparoscopy was performed for relieving the obstruction of duodenum.After 7 months,thoracoscopic esophagectomy and anastomosis were performed.Conclusion CES often has concomitant gastrointestinal malformations easily to be neglected.Treatment has remained controversial and endoscopy is both feasible and effective.
作者
华凯云
赵勇
谷一超
廖俊敏
李爽爽
张雅楠
杜京斌
吴丹
黄金狮
Hua Kaiyun;Zhao Yong;Gu Yichao;Liao Junmin;Li Shuangshuang;Zhang Yanan;Du Jingbin;Wu Dan;Huang Jinshi(Department of Neonatal Surgery,National Center of Children s Health,Beijing Children Hospital,Capital Medical University,Beijing 100045,China)
出处
《临床小儿外科杂志》
CAS
2020年第4期342-346,共5页
Journal of Clinical Pediatric Surgery
