食管重建术在小儿食管化学性烧伤瘢痕狭窄中的应用

目的 总结食管重建术治疗小儿化学性烧伤后瘢痕狭窄的经验。探讨此疗法常见并发症的预防。方法 本组28例均应用保留横结肠左动脉升支和经胸骨后隧道顺蠕动间置结肠，行结肠食管颈部吻合20例，结肠咽腔吻合8例，手术时间为伤后3周-1年，其中10例在伤后3-4周内手术，结果 无手术死亡，术后颈部吻合口瘘1例，吻合口狭窄1例，术后气管切开1例。经治疗后进普食均顺利，随访1-22年，患儿发育正常。结论 小儿食管化学性烧伤后瘢痕狭窄应积极采取胸骨后横结肠代食管，行食管结肠颈部吻合或结肠咽腔吻合。

Esophageal reconstruction for caustic esophageal stricture in children

Objective To sum up the experience in teating caustic esophageal stricture by esophageal reconstruction in children and preventing the common complications. Methods From 1972 to 1999, 28 children with full length caustic esophageal stricture were treated surgically, in whom 20 underwent esophagocologastrostomy and 8 colonphargageal anastomosis. The ascending branch of the left artery of the transverse colon was preserved as the supporting vessel of the inter positioned colon. Results There was no death involved in the operation. Follow up study (1 22 years) revealed that all the patients grew normally. The leakage of cervical anastomosis occurred in 1 patient, anastomosis stenosis in 1 patient, and tracheotomy was performed in 1 patient. Conclusions Esophageal reconstruction with transverse colon interposition by esophagocologa strostomy or colonphargageal anastomosis is an optimal approach to the treatment of full length caustic esophageal stricture in children.