食管缺损的显微外科修复与重建

目的 探索食管狭窄，闭锁或缺损的修复与重建，手术适应证，手术要点及并发症的防治。方法 采用吻合血管的带蒂空肠，游离空肠，肠瓣及前臂皮瓣移植等手术对化学灼伤或其它原因致全食管，上胸段及颈段食管狭窄或闭锁的病人进行修复与重建，结果 成功４４例，失败１例，结论吻合血管的带蒂或游离空肠及肠瓣移植修复与重建是治疗食管狭窄，闭锁，缺损的理想手术方法。经腹部多次手术的颈段食管缺损病人可采用吻合血管的皮瓣或皮管移

Microsurgical reconstruction of esophageal defect

Objective To explore the procedures of repair and reconstruction of the esophageal stricture, stenosis, fistula and defects, their indications, key points of operation and prevention of complications Methods Microsurgical procedures as transference of vascularized jejunal segment, vascularized pedicled jejunum and vascularized jejunal flap patch and free forearm skin flap were performed since 1980 in 45 cases of esophageal stenosis, stricture of defect caused by resection of carcinoma, chemical burn or diphtheria Results Operation had been successfully performed in 44 cases and had been given up due to technical fault in one case Postoperative complication of acute esophageal dilatation due to over eat occurred in two cases Revisional transverse colon transfer was done with success in an adult case In one child case, the patient died of intrathoracic perforation of the volvulous esophagus Conclusions Microsurgical reconstruction of vascularized jejunal graft, vascularized pedicled jejunal transfer, free forearm skin graft or vascularized jejunal flap patch are ideal procedures in reconstruction or repair of stenosis, stricture, fistula or defect of esophagus In those cases who had experienced several abdominal operations already or refused to have jejunum graft, vascularized forearm skin flap may be chosen too