食管腐蚀伤外科治疗中的几个问题探讨

Discussion on the Problems in the Surgical Treatment of Esophageal Corrosive Burn

本文报告我科外科治疗之食管腐蚀伤８４例，９１．７％为碱性腐蚀伤。２３例采用食管腔内置管预防狭窄，优良效果２０例，占８４．７％；结肠代食管３６例，死亡３例（８．３％），胃代食管和局部成形１１例均治愈，其他手术１７例。本文对食管腔内置管、狭窄瘢痕是否切除及食管重建进行了讨论，并介绍了颈阔肌皮瓣修复吻合口狭窄的体会。

This paper reports the experince of surg ical treatment of esophageal corrosive burn in 84 cases,The corrosive agents in this series were lye or caustic soda in 77 (91.7%) and caustic acid in 7 (8.3%). Intraluminal stent ings were applied to prevent esophageal stri ictures in 23 cases and good effects were obta 1ned in 20 cases(87%). Other procedures inc luded colon bypass in 36(postoperative death in 3),gastric transposition arid local esop hagoplastomy in 11 cases with excellent resu lts and other operations in 14 The value of the intraluminal stenting preventing esopgageal strictures, the replacement of the esophagus and problem resecting strictured esophagus or not are discussed. The e experiences of the platysma myocutaneous flaps to repair the anastomotic stricture in the neck is also introdued in this paper.