Hua Kaiyun,Zhao Yong,Gu Yichao,et al.Diagnosis and treatment of congenital esophageal stenosis: a report of 4 cases[J].Journal of Clinical Pediatric Surgery,2020,19(04):342-346.[doi:10.3969/j.issn.1671-6353.2020.04.012]
先天性食管狭窄4例报告及诊治经验分析
- Title:
- Diagnosis and treatment of congenital esophageal stenosis: a report of 4 cases
- 分类号:
- R655.4;R726
- 摘要:
- 目的 探讨先天性食管狭窄的诊断及治疗方式。方法 回顾性分析首都医科大学附属北京儿童医院2015年6月至2018年12月收治的4例先天性食管狭窄患儿的临床资料。4例患儿均为男性，入院年龄分别为5岁1个月、4岁2个月、10个月和3岁7个月。结果 1例入院后诊断为贲门失迟缓症，在腹腔镜食管肌层切开过程中发现食管下段软骨异位，切除异位软骨后保留完整食管黏膜，随访1年进食顺利。1例先天性食管闭锁合并食管下段狭窄，多次影像学检查漏诊食管下段狭窄，胸腔镜下完成狭窄段切除再吻合，随访8个月进食顺利。1例球囊扩张食管4次，随访4个月进食顺利。1例先天性食管狭窄合并十二指肠梗阻，腹腔镜解除十二指肠梗阻7个月后行胸腔镜食管切除再吻合手术，随访2个月进食顺利。结论 先天性食管狭窄常合并其它消化道畸形，容易漏诊，其治疗方式尚存在争议，腔镜手术具有较高可行性。
- Abstract:
- Objective To explore the diagnosis and treatment of congenital esophageal stenosis (CES). Methods Retrospective analysis was conducted for the clinical data of 4 CES boys from June 2015 to December 2018.The ages of admission were 61,50,10 and 43 months respectively. Results Case 1 was diagnosed as achalasia cardia after admission.During laparoscopic esophageal myotomy,ectopic cartilage in lower esophagus was removed with intact esophageal mucosa.Case 2 had CES associated with esophageal atresia.Lower esophageal stenosis was missed for several times.And thoracoscopic stenosis resection and re-anastomosis were performed.Case 3 had stenosis of lower esophagus and balloon-dilate was performed for 4 times.Case 4 had CES with multiple duodenal obstructions and laparoscopy was performed for relieving the obstruction of duodenum.After 7 months,thoracoscopic esophagectomy and anastomosis were performed. Conclusion CES often has concomitant gastrointestinal malformations easily to be neglected.Treatment has remained controversial and endoscopy is both feasible and effective.
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备注/Memo
收稿日期:2019-02-19。
通讯作者:黄金狮,Email:jsdr2002@126.com