食管重建术后并发症的内镜诊断和处理

目的 对食管重建术后患者的上消化道病变进行内镜诊断和治疗。 方法 食管重建患者54例,术后3周-3年进行内镜随访检查。 结果 残余食管、吻合口和代食管病变的发生率分别为11.6％,69.0％和27.8％。食管重建后患者最常见的疾病为非特异性残余食管炎、吻合口炎及不同程度的吻合口狭窄和慢性胃炎。对5例吻合口重度狭窄患者成功地进行了内镜下吻合口狭窄切开或切开 扩张治疗。 结论 内镜检查有助于食管重建术后并发症的诊断,对作咽造口 食管旁路术患者也是安全可行的。对某些严重吻合口疤痕狭窄者内镜下电切 扩张治疗可解除症状。

Gastroscopic diagnosis and management of the complica-tions of post - esophageal reconstruction

AIM Upper GI tract disorders in patients with reconstructed esophagi were diagnosed and treated gastroscopically.METHOD Fifty four patients were followed up gastroscopically 3 weeks to 3 years after the operations of the esphageal reconstructions. RESULTS The incidences of the disorders of the residual esophagi, inflammation of stomata and the replacements were 11.6%, 69.0% and 27. 8% respectively. The inflammation of stomata and various degrees of stenoses of the stomata, the nonspecific esophagitis of the residual esophagi and the chronic gastritis of the replacements of the esophagi were the most common diseases of the patients with reconstructed esophagi. The severe scarring stenoses of the stomata in 5 patients were successfully treated by elcctrotomy or electrotomy with dilatation.CONCLUSION Gastroscopy is very useful for diagnosis of complications of esophageal reconstruction, and is also safe and feasible for examination on patients with pharyngotomy with esophageal bypass. The endoscopic electrotomy plus dilatation could relieve the symptoms of some scarring stenoses of the stomata.