成功同时治疗食管切除术后结肠夹层引起的良性狭窄和结肠肿瘤一例报告。

Seung Hee Kim, Jin Won Kim, Seon-Young Park, Hyun-Soo Kim, Chae June Lim, Gang Han Lee, Jae Woong Lim, Young Eun Seo, Shin Young Park, Yo Han Lee, Yong-Wook Jung, Woo Rim Kang, Hye-Su You, Dong Hyun Kim
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引用次数: 0

摘要

结肠间置术是食管重建的主要方法。我们报告了一个罕见的同时治疗吻合口狭窄和植入结肠肿瘤的病例。一位69岁的女性因进行性吞咽困难症状就诊于我们的门诊1年。30岁时,患者因摄入化学物质后严重食道烧伤,接受了胸骨后结肠间置的食管切除术。上消化道内窥镜检查显示吻合口狭窄,插入结肠内有10mm平坦的高度不典型增生。首先,通过内镜进行球囊扩张治疗狭窄。然而,在第二次上消化道内窥镜检查期间观察到狭窄。因此,进行了第二次经内镜球囊扩张,同时也成功地进行了内镜黏膜下剥离。随访2个月后,狭窄持续存在;因此,进行了球囊扩张术。经内镜检查,肿瘤未复发。通过内镜球囊扩张狭窄部位,并同时在内镜下对插入结肠的肿瘤进行黏膜下剥离。
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Successful Simultaneous Treatment of Benign Stricture and Colonic Neoplasm Arising from Colonic Interposition after Esophagectomy: A Case Report.

Colonic interposition is the main procedure used in esophageal reconstruction. We report a rare case of simultaneous treatment of an anastomotic site stricture and a neoplasm in the interpositioned colon. A 69-year-old female visited our outpatient clinic with symptoms of progressive dysphagia for 1 year. At the age of 30 years, the patient underwent esophagectomy with retrosternal colonic interposition because of severe esophageal burns after chemical ingestion. Upper gastrointestinal endoscopy revealed stricture at the anastomosis site and a 10-mm flat elevated high-grade dysplasia in the interpositioned colon. First, through-the-scope balloon dilatation was performed for strictures. However, stenosis was observed during the second upper gastrointestinal endoscopy session. Therefore, a second session of through-the-scope balloon dilatation was performed, and simultaneously, endoscopic submucosal dissection was also successfully performed. After 2 months of follow-up, stenosis persisted; consequently, balloon dilatation was performed. No recurrence of neoplasm was confirmed endoscopically. Through-the-scope balloon dilatation of the stricture site and simultaneous endoscopic submucosal dissection of the neoplasm in the interpositioned colon were successfully performed.

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