经胸骨后隧道间置结肠代食管治疗腐蚀性食管烧伤后瘢痕狭窄

目的 探讨经胸骨后隧道间置结肠替代食管术式治疗腐蚀性食管烧伤后瘢痕狭窄的临床经验及并发症的治疗。方法 对65例食管腐蚀性烧伤后瘢痕狭窄患者，分别行顺蠕动结肠代食管经胸骨后至颈部与食管端端吻合（56例）、顺蠕动结肠代食管经胸骨后至咽底吻合（7例）、逆蠕动结肠代食管经胸骨后至颈部与食管端端吻合（2例）治疗，总结上述病例术前、术中、术后治疗经验。结果 术后51例患者恢复顺利痊愈出院。12例术后出现颈部吻合口瘘，其中2例经再次颈部手术治愈，10例保守治疗痊愈。2例术后发生结肠坏死，再次手术死亡1例，痊愈1例。结论 治疗腐蚀性食管烧伤可以旷置瘢痕食管，在良好术前准备、准确的外科操作、正确的术后处理前提下，经胸骨后隧谱闻詈结肠巷代食管术式杆集满帝．

Reconstructive operation with transpositional colon behind sternum for esophageal stricture after corrosive burns

Objective To summarize clinical experience of reconstructive operation with transpositional colon behind the sternum after corrosive esophageal bums and to explore the treatment for its complications. Methods Clinical data of 65 cases with esophageal scarred stricture after corrosive bums receiving reconstructive operation with transpositional colon behind the sternum were reviewed, 56 of them by end-to-end anastomosis between transpositional anterograde peristaltic colon and esophagus, seven by end-to- end anastomosis between transpositional anterograde peristaltic colon and pharyngeal fundus, and two by end-to-end anastomosis between transpositional reversed peristaltic colon and esophagus, to summarize treatment experiences in pre-operation, operation and post-operation. Results Fifty-one of this group of patients recovered and discharged form the hospital smoothly, 12 with cervical anastomotic leakage after operation including two cured by re-operation and ten cured by conservative treatment, and two with necrosis of transpositional colon including one died during operation and the other cured. Conclusions Corrosive bums of esophagus can be cured by leaving scarred stricture esophagus open without resection, and the effectiveness of reconstructive operation with transpositional colon behind the sternum is satisfactory with good pre-operative preparation, correct surgical operation, and correct post-operative treatment.