下咽食管狭窄的治疗

目的：探讨下咽食管狭窄的重建术，以取得更好的治疗效果。方法：总结３５例下咽食管狭窄患者的治疗方法，包括类固醇激素和抗生素治疗、扩张治疗、下咽食管成形术（胸大肌肌皮瓣、胸三角肌皮瓣、胸锁乳突肌皮瓣、他厚皮片、结肠上徙、胃上提、游离空肠、瘢痕切除局部粘膜减张缝合或纵切横缝）。结果：３５例中，３３例治愈，恢复正常饮食。经１￣１９年的随访治愈病例未出现狭窄复发，疗效巩固。结论：早期轻度的下咽食管狭窄可采用

The treatment for hypopharyngoesophageal stenosis

Objective:In order to improve the curative effects of treatment on hypopharyngoesophageal stenosis.Method:35 patients with hypopharyngoesophageal stenosis were retrospectively reviewed.The curative methods were selected on the basis of different pathologic conditions,including using of steroids,antibacterial ,dilatation,reconstruction of hypopharynx and oesophagus with ectopectoralis musculocutaneous flap,thoracal deltoid muscle flap,sternocleidomastoid musculocutaneous flap,full thickness graft,colon and stomach interposition,free jejunal grafts,local mucous membrane flap.Result:With a follow up from 1 year to 19 years,33 patients resumed a normal oral diet and had no stenosis of anastomosis .Conclusions:For those who have the early mild lesions,using of steroids,antibacterial and dilatation are considered to be the choice procedure;for thos who have severe lesions,petforming reconstruction of hypopharynx and oesophagus is necessary.The ectopectoralis musculocutaneous flap or local mucous membrane flap is the first choice for treatig hypopharyngeal stenosis,while oesophageal reconstruction using the colon interposition can obtain good results.The ectopectoralis musculocutaneous flap and colon interposition are reliable and safe stuffs and appropriate to most of the hypopharyngoesophageal stenosis.