食管、贲门癌术后吻合口狭窄扩张术的经验

食管扩张术适合于食管、贲门癌术后吻合狭窄,也可用于腐蚀性灼伤之疤痕狭窄。本组对267例术后狭窄患者行扩张术1122次,57％患者获较好效果。扩张术中所见以疤痕性环形狭窄为多,占56.9％。此类病人进食困难明显,扩张后效果较好。形成狭窄之原因为吻合时缝线在同一平面所致。近期我们采用食管置入法,对预防狭窄有初步效果。穿孔及出血为扩张术之严重并发症,故对拟行扩张之病人,必须有一周内之食管造影片,以了解吻合口的狭窄程度及有无溃疡存在。对扩张后有胸腹痛者,须住院观察,必要时及早拍摄胸片及食管造影。

Dilatation of Stricture of Esophageal Anastomosis

Dilatation was done to treat anastomotic stricture after esophagogastrostomy for carcinoma of esophagus or cardia, Of the 267 cases (1,122 times) thus treated 57% achieved satisfactory results. Cicatricial ring stricture at the anastomotic site was seen in 56.9% of this series. Under such circumstances the patients usually suffered from severe dysphagia and as a rule dilatation brought about satisfaction. The main complications of dilatation were bleeding and rupture of esophagus, In the event of pain in the chest or abdomen after dilatation, the patient should be hospitalized and put under close observation, and X-ray examinations be done without delay when necessary.