三种方法食管替代治疗腐蚀性食管损伤的效果分析结肠介入,胃上拉,反胃管

Arash Khashayar, Ahmad Khaleghnejad Tabari, L. Mohajerzadeh, J. Ghoroubi, Mahdieh Samami
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摘要

背景:腐蚀性食管损伤所引起的粘膜损伤与摄入物质的种类、暴露时间和摄入量有关,从轻度烧伤到重度坏死不等。这通常发生在儿童时期。狭窄和吞咽困难是常见的。吞咽问题是由于长期的狭窄,需要手术。然而,术后问题也应考虑。本研究的目的是确定三种方法中食道替代治疗腐蚀性食管损伤的效果;结肠介入,胃上拉,反胃管。方法:本观察性描述性比较研究纳入2006 - 2016年在Mofid儿童医院连续就诊的50例患者,并分析三种方法中食道替代治疗腐蚀性食管损伤的结果;确定其中结肠介入、胃上拉、反胃管,并根据其他变量进行比较。结果:本研究结果显示68%的患者需要手术,82.3%的患者需要重复手术。其中22例采用胃上拉法,多数患者成功。食道狭窄(74%)、呕吐(46%)和吞咽困难(40%)是术前最常见的问题,吞咽困难(46%)、狭窄(36%)和呕吐(26%)是术后最常见的问题。死亡病例4例。结论:总的来说,根据所获得的结果,可以得出食管替代治疗腐蚀性食管损伤是有效的,胃上拉法是最好的选择。
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Outcomes of esophagus substitution in the management of corrosive esophageal injury in three methods; colon interposition, gastric pull up, and reverse gastric tube
Background: The corrosive esophageal injury would result in mucosal damage related to type, exposure time, and volume of ingested substance ranging from mild burn to severe necrosis. It is usually seen in childhood. Stricture and dysphagia are common. Swallowing problems are due to prolonged stricture and would require surgery. However postoperative problems should also be considered. The purpose of this study was to determine the results of esophagus substitution in the management of corrosive esophageal injury in three methods; colon interposition, gastric pull up, and reverse gastric tube. Methods: In this observational descriptive-comparative study, 50 consecutive patients attending to Mofid children hospital since 2006 to 2016 were enrolled and the results of esophagus substitution in the management of corrosive esophageal injury in three methods; colon interposition, gastric pull up, and reverse gastric tube among them were determined and compared according to other variables. Results: The results in this study demonstrated that 68% required surgery that 82.3% had repeat surgery. Out of them 22 were performed with Gastric Pull up method that was successful in majority of subjects. Esophageal stricture (74%), vomiting (46%), and dysphagia (40%) were most common preoperative problems and dysphagia (46%), stricture (36%), and vomiting (26%) were most common postoperative problems. There were 4 mortality cases. Conclusion: Totally, according to the obtained results, it may be concluded that esophagus substitution in the management of corrosive esophageal injury is effective that Gastric Pull up method is best option.
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