贲门成形术加胃底折叠治疗食管失弛缓症(附20例报告)

本文报告了我科设计的贲门成形加胃底折叠术治疗食管失弛缓症20例的体会。通过临床观察,食管X线吞钡检查,食管动力学研究及酸性灌注试验等证实这种手术方法既可消除进食梗阻又可防止返流,操作也不复杂。文中结合临床和动物实验研究,讨论了胃底折叠的松紧度和这种手术抗返流的机理。

The Clinical and Experimental Studies of Cardioplasty with Total Fundoplication in the Treatment of Esophageal Achalasia

20 cases of esophageal achalasia are treated with cardioplasty and total fundoplication designed by the Thoracic Department. Through Jan 1982 to July 1987 among the 20 patients treated no postoperative complications, gas blaot syndrome, gastroesophageal reflux and death occurred. The operation consists of cardioplasty, incising all the layers of the constrictive portion of the esophagus longitudinally and suturing transversally to relieve the dysphagia, and fundoplication to prevent postoperative relur. The clinical and experimental studies prove that this procedure fits the principles of surgical treatment in esophageal achalasia. A hard tube of 1-1.2cm in diameter as a trestle during fundoplication is used. Thus the lower esophageal sphincter pressures before and after operation are not statistically different.The operative method is described and the mechanism of antirelux is discussed.