食管入口周围严重狭窄的手术治疗

Surgical treatment for severe stenosis of esophageal access

目的:探讨有效治疗食管入口周围严重狭窄的手术方法。方法:对2000-2009年完成的23例食管入口周围严重狭窄的患者进行回顾性分析,根据病情分别采用不同的治疗手段。对伴有下咽狭窄者,采用食管扩张、局部黏膜成形、胸大肌肌皮瓣、结肠上徙、空肠移植等方法整复;对伴有喉狭窄者,采用胸骨舌骨肌肌筋膜、会厌下拉、胸锁乳突肌锁骨衣等方法整复。结果:22例恢复正常饮食,1例失败,21例拔除气管套管。经1～9年的随访,未发生再狭窄,手术效果稳固。结论:对食管入口处严重狭窄的患者根据病情采取合理的手术方法,疗效良好。

Objective：To evaluate the surgical management for the severe stenosis of peripheral esophageal access.Method：Twenty-three patients who underwent severe stenosis of peripheral esophageal access from 2000 to 2009,were retrospectively reviewed.The surgical plan was selected by considering the stage of stenosis,dilatation,reconstruction of hypopharynx、oesophagus or larynx.Result：Twenty-two patients resumed a normal oral diet and 21 cases succeeded in decannulation,no stenosis recurred after a 1-9 years follow-up.Conclusion：The severe stenosis of peripheral esophageal access can get good results when the appropriate surgical plan were choiced.