食管化学烧伤后狭窄的重建手术

目的探讨食管化学烧伤后狭窄的外科治疗经验及横结肠代食管重建手术的应用价值。方法137例食管化学烧伤后狭窄的患者中112例采用横结肠代食管、保留结肠左动脉升支、胸骨后顺蠕动吻合，其中横结肠咽腔吻合34例，横结肠食管颈部吻合78例；25例采用胸骨后胃咽腔或胃食管颈部吻合。结果无手术死亡病例。手术后发生颈部吻合口瘘14例，吻合口狭窄11例，气管切开4例，经治疗后均痊愈。结论食管化学烧伤后应积极采取食管重建术，采取胸骨后横结肠代食管术，行横结肠食管颈部吻合或结肠咽腔吻合都是适宜的。

Surgical treatment of esophageal reconstruction for caustic esophageal stricture

Objective To review the experience of surgical management for caustic esopha- geal stricture and discuss the surgical techniques of transverse colon interposition for esophageal replacement. Methods One hundred and twelve cases of 137 patients with caustic esophageal stricture were treated surgically. Thirty - four patients underwent colon interposition and 78 esophagogastrostomy in the neck or pharynx. Twenty - five cases with cerrical anastomosis stenosis were treated surgically with esophagogastrostomy in the neck or pharynx. Results There was no postoperative death. The leakage of cervical anastomosis was observed in 14 patients, anastomosis stenosis in 11 patients, and tracheotomy was performed in 4 patients. All patients were perfectly recovered by the treatment. Conclusions Transverse colon interposition for esophageal reconstruction is an optimal approach in the treatment of caustic esophageal stricture.