儿童梨状窝瘘反复发作的原因与胃镜辅助手术

目的分析儿童梨状窝瘘反复发作的原因，介绍胃镜辅助手术方法及其优越性。方法12例患儿。男8例，女4例，年龄2．5～9岁；曾行左颈部瘘管或囊肿切除术8例，左颈部反复感染者4例；吞钡造影、B超、CT、同位素扫描等检查诊断为梨状窝瘘。12例均行胃镜辅助瘘管切除术。取此前未经胃镜辅助而直接手术的8例临床资料作对照。结果经胃镜辅助切除瘘管，平均手术时间1h 35min，术后恢复顺利，随访无复发。对照组手术时间长，2例复发。结论缺乏对梨状窝瘘胚胎发生和病理过程的了解是治疗失误的主要原因，胃镜辅助手术是一种简便、有效的治疗手段。

Gastroscopic assistant operation for children with pyriform sinus fistula

Objective To evaluate the effect of gastroscopic assistant operation for children with pyriform sinus fistula. Methods The clinical data of 12 patients (male 8 and female 4) aged from 2.5 to 9 years with pyriform sinus fistula were retrospectively analyzed. Recurrent infections after fistulectomy or cystectomy were noted in 8 patients. The other 4 patients presented with twice or more episodes of infection. The diagnosis was identified by esphagogram, CT, ultrasonography, and scintigraphy. All 12 patients underwent gastroscopic assistant fistulectomy. Eight patients heretofore underwent fistulectomy regarded as control group. Results In gastroscopic assistant operation group, the mean operation time was 1 h and 35 min. All patients did well postoperatively and shown no recurrences during follow up term. In control group, the mean operation time was longer, recurrent infection had been noted in two patients.Conclusions Gastroscopic assistant operation is a simple, quick and effective operation for children with pyriform sinus fistula.