[1]邬文杰,潘伟华,严文波,等.食管盲袋翻转成形食管延长术治疗Ⅰ型食管闭锁的疗效分析[J].临床小儿外科杂志,2018,17(03):174-178.
　Wu Wenjie,Pan Weihua,Yan Wenbo,et al.Clinical study to treat pure esophageal atresia with cystic pouch of proximal esophagus.[J].Journal of Clinical Pediatric Surgery,2018,17(03):174-178.
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食管盲袋翻转成形食管延长术治疗Ⅰ型食管闭锁的疗效分析

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第17卷 期数: 2018年03期 页码: 174-178 栏目: 专题讨论 出版日期: 2018-03-28
Title:
Clinical study to treat pure esophageal atresia with cystic pouch of proximal esophagus.
作者:
邬文杰; 潘伟华; 严文波; 等
上海交通大学医学院附属新华医院
Author(s):
Wu Wenjie1; Pan Weihua1; Yan Wenbo1; Xie Wei2; Gong Yiming1; Wang Jun1.
1. Department of pediatric surgery，Xinhua Hospital，Shanghai Jiao Tong University School of Medicine.Shanghai 200092，China;
关键词:
食管闭锁;  近端囊袋样扩张;  舌状襻翻转
Keywords:
Esophageal Atresia;  Cystic Pouch of Proximal Esophagus;  Flap
文献标志码:
A
摘要:
目的　探讨利用近端食管盲端呈囊袋样扩张所可能产生的较为富裕的自身食管组织舌状襻翻转后管状成形以延长食管，从而达到一期食管重建的目的，进而提高Ⅰ型食管闭锁的疗效。　方法　回顾性分析本院２０１２ 年４ 月至２０１４ 年２ 月收治的３ 例近端食管盲袋呈囊袋状扩张的Ｉ 型食管闭锁患儿临床资料。经造影观察并多维度测量近端盲端食管的长度、宽度，预估可能翻转并形成食管延长的长度，评估一期食管重建的可能性。同时检索Ｐｕｂｍｅｄ、Ｅｍｂａｓｅ、Ｗｅｂ ｏｆ Ｓｃｉｅｎｃｅ 数据库，检索词为“ ｅｓｏｐｈａｇｅａｌ ａｔｒｅｓｉａ／ ｆｌａｐ” ，对２０１６ 年１２ 月前报道的采用近端食管盲袋翻转成形食管重建术治疗的先天性食管闭锁文献资料进行复习。　结果　３ 例均一期完成食管重建，翻转后延长食管长度２． ５ ～ ３ ｃｍ，术
后发生吻合口漏３ 例，吻合口狭窄２ 例，分别经保守治疗和球囊扩张后痊愈出院。出院随访３ ～ ５ 年，无一例喂养困难或反复呼吸道感染。复习国外文献获得病例８２ 例，其中Ⅰ型１１ 例，Ⅲ型７０ 例，Ⅳ型１例。　结论　近端食管盲袋翻转成形食管重建术是治疗近端食管呈囊袋状扩张的Ⅰ型先天性食管闭
锁的有效方法，食管本身作为替代物优势明显，术后远期功能较好。
Abstract:
ObjectiveTo summarize the clinical experience of upper esophageal flap repair for pure esophageal atresia with cystic pouch of proximal esophagus，and to improve the longterm esophageal function.MethodsRetrospective analysis of 3 consecutive patients admitted into our department from April 2012 to February 2014 about the esophageal diameter，the distance between two esophageal pouches，the length of esophageal elongation and complications.More clinical cases were retrieved from the databases of Pubmed，Embase and Web of Science prior to December 2016.ResultsAll infants survived postoperatively.The postoperative complications were anastomotic leakage (n=3)，stenosis (n=2).The overall followup period was 3 to 5 years.Through literature retrieved，82 cases were included for this study.ConclusionUpper esophageal flap esophagoplasty is an effective treatment for pure EA with cystic pouch of proximal esophagus.As the esophageal prosthesis，autogenous esophagus has good functions.

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