Collis联合胃底折叠术治疗儿童先天性食管下段狭窄二例

发布时间：2018-08-29 18:30

【摘要】：目的总结Collis联合胃底折叠术治疗2例儿童先天性食管下段狭窄的诊治体会。方法 2015年12月及2016年6月收治2例先天性食管下段狭窄男性患儿,年龄均为2岁;均有反复呕吐史,伴营养不良。其中1例因重度营养不良行胃造瘘术,8个月后行该次手术。术前2例均行食管下端球囊扩张1次无效。行Collis术联合胃底折叠术,同时行幽门成形。结果 2例手术均顺利完成,手术时间分别为120、180 min,术中出血量15、20 mL。狭窄段组织病理检查提示为异位气管支气管软骨。术后1周上消化道造影示吻合口无狭窄及漏,无明显胃食管反流。2例患儿均获随访,均开始进普食,无吞咽困难;体质量较术前明显增加。术后6个月上消化道造影检查示吻合口通畅。结论 Collis联合胃底折叠术是治疗儿童先天性食管下段狭窄的一种较好方法,合理的手术方案设计和手术精细化操作,可以减少术后并发症。
[Abstract]:Objective to summarize the experience of Collis combined with fundus folding in the treatment of 2 children with congenital lower esophageal stenosis. Methods two cases of male children with congenital lower esophageal stenosis were treated in December 2015 and June 2016, both aged 2 years, all of whom had a history of repeated vomiting and malnutrition. One patient underwent gastrostomy because of severe malnutrition and 8 months later. Before operation, all cases underwent dilatation of the lower end of esophagus with one time of balloon dilatation. Collis combined with fundus folding and pyloroplasty were performed. Results the two cases were successfully completed, and the operative time was 120180 min,. The amount of blood lost during the operation was 15 ~ 20 mL.. Histopathological examination of stenosis showed ectopic tracheobronchial cartilage. 1 week after operation, the upper digestive tract angiography showed that there was no stenosis or leakage of anastomotic stoma, no obvious gastroesophageal reflux. All the cases were followed up, all of them began to take common food and had no dysphagia, and the body mass increased obviously compared with that before operation. 6 months after operation, upper gastrointestinal angiography showed patency of anastomotic stoma. Conclusion Collis combined with fundus folding is a better method for the treatment of congenital lower esophageal stenosis in children. Reasonable design of operation plan and fine operation can reduce postoperative complications.
【作者单位】：上海交通大学医学院附属上海儿童医学中心普外科;
【分类号】：R726.5

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