摘要
目的 总结 32例先天性食管闭锁手术治疗经验。方法 手术均采用食管上盲端前壁肌层U形翻转 ,即经胸膜外入路充分游离食管上端及瘘管 ,近气管侧缝扎切断瘘管。用剪刀将远端食管前壁纵行剪开 5mm ,吻合前距吻合口上方 1 0mm处行食管上下两端浆肌层缝合 3针 ,然后距吻合口上方1 5～ 2 0mm处将食管前壁肌层切开 ,从切开处向吻合口方向从两侧纵行切开肌层至吻合口约 5mm ,轻轻分离前壁肌瓣 ,形成U形向下翻转 ,缝合在食管远端浆肌层上。结果 32例中 1 7例采用此方法未发生吻合口瘘 ,1例吻合口狭窄。 2例成功行一期胃代食管术。结论 食管上盲端前壁肌瓣U形翻转能有效预防吻合口瘘及狭窄。I、II型食管闭锁采用一期胃代食管术 ,可避免二次手术。
Objective To review the experience of surgical treatment of congenital esophageal atresia. Methods From 1987 to 2001, 32 patients with congenital esophageal atresia were treated surgically, 13 patients using the traditional method, 17 using the new method and 2 using esophago gastric reconstruction. Results There was no postoperative mortality in all patients. There was one anastomosis leak and 4 anastomosis stricture. No anastomosis leak and one esophageal stricture in the patients recieved new method. Conclusion The new surgical method for congenital esophageal atresia can effectively prevent postoperative anastomosis leak and stricture. One stage esophago gastric reconstruction can be used in type I and type II esophageal atresia and instead of two stage operation.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2004年第5期259-260,共2页
Chinese Journal of Thoracic and Cardiovascular Surgery
