食管及贲门癌术后吻合口狭窄气囊导管扩张术及预后评价

Follow-up evaluation of balloon dilation in stricture after operating of esophageal and cardiac careinoma

目的:评价食管和贲门癌术后吻合口狭窄气囊导管扩张术的治疗效果。方法:57例(男31例,女26例)吻合口狭窄作了气囊导管扩张术,其中食管-胃吻合54例,食管-空肠吻合3例。作1次扩张术者28例,2次扩张术者15例,3次扩张术者5例,4次扩张术者9例。全部病例均在门诊随访和作钡餐造影随访观察。结果:本组病例于末次扩张术后经2mo～36mo(平均21mo)的随访观察,疗效满意者44例(77.2％);扩张无效者13例(22.8％),给予放置金属内支架治疗。采用丝线和采用金属吻合钉吻合的两组吻合口的扩张术疗效对比无显著性意义(x^2=0.138,P>0.05);扩张术前吻合口最大舒张期直径0.2cm～0.3cm 和0.4cm～0.5cm 两组之间的疗效差异也无显著性意义(x^2=0.235,P>0.05);扩张术前吻合口长度0.2cm～0.4cm,0.5cm～1.0cm,1.1cm～4.5cm 三组之间的疗效差异有显著性意义(x^2=7.746,P<0.05)。结论:食管及贲门癌术后吻合口狭窄气囊导管扩张术简单、安全而有效,应作为首选的治疗方法。金属内支架置入可作为气囊导管扩张术无效的补救治疗措施。

To evaluate the results of balloon dilation in benign stricture after operation of esophageal and cardi- ac carcinoma.METHODS:54 cases with esophagogastrostomy and three cases with esophagojejunostomy were studied.All cases with benign stricture of the anastomotic stoma were,treated with balloon dilation.Among them,28 cases were per- formed in once,15 cases in twice,5 cases in three,9 cases in four,All of them were follow up with exophagography in clinic.RESULTS:57 cases were followedup for 2-36 months(average 21 months).Good results were achieved in 44 cases(77.2%),and metallic stents were implanted as dilation were insuccuss in 13 cases(22.8%).The difference be- tween 0.2cm-0.3cm and 0.4cm-0.5cm on the maximal relaxation diameter of anastomotic stoma before dilation was no significance too (x^2=0.236,P>0.05).The difference among three groups 0.2cm-0.4cm,0.5cm-1.0cm and 1. 1cm-4.5cm on length of anastomotic stoma before dilation was statistically significant (x^2=7.746,P<0.05 ).CON- CLUSION:Balloon dilation is simple,safe and efficient method for benign stricture after operation of esophageal and car- diac carcinoma,and stents implanted was remedy measure for dilation inefficiency.