临床小儿外科杂志2016，Vol.15Issue(3)：268-271,4.DOI:10.3969/j.issn.1671-6353.2016.03.018
33例先天性食管狭窄的诊治分析
Diagnosis and treatment of congenital esophageal stenosis
雷洪波 1吴春 1潘征夏 1杨杰先 1范颖1
作者信息
- 1. 重庆医科大学附属儿童医院心胸外科重庆 市，400010
- 折叠
摘要
Abstract
Objetive Congenital esophageal stenosis (CES)is a rare malformation.And esophageal dilations and surgical resection are routine treatments.To explore the clinical diagnosis and treatment of CES soas to reduce the rate of its misdiagnosis and improve its early treatment. Methods A retrospective study wasconducted for 33 CES cases undergoing esophageal dilatation or operation from 1990 to 2012.Their clinicalmanifestations,diagnosis,treatment and pathological findings were reviewed. Results Only 17 cases(51%)were diagnosed correctly preoperative.And the rate of misdiagnosis was 49% for initial visitors and even higherfor tracheobrochial remnants.(72%)Symptoms of dysphagia and regurgitation developed at a mean age of8.6,definitive treatment was offered at a mean age of 33.8 with a time lag of almost 2 years from the onset ofsymptoms.Clinical manifestations included postprandial vomiting,regurgitation,failure of thriving,dysphagiaand anemia.The underlying diagnosis was usually confirmed by medical history,esophagogram and histopathological examination of resected segment.Esophagography,as a primary diagnostic tool,was performed in allpatients.After a mean followup period of 3 years (1 month to 10 years ),26 patients(79%)required operations.The postoperative complications included anastomotic stenosis,anastomotic,gastroesophageal reflux aftera mean follow -up period of 3 years (range,1 month to 10 years).There was no case of mortality.Operationwas the treatment of choice and carried little morbidity and mortality.CES could be classified based on the histological type of stenosis.There were tracheobronchial remnants (TBR,n =13)and fibromuscular hypertrophyor web (FMH,n =8).Conclusions CES should be suspected in patients with a typical history of recurrentvomiting and dysphagia and characteristic esophagographic findings.If dilation is ineffective,operation is anoptimal treatment with a low morbidity and mortality.关键词
食管狭窄/先天性/食管狭窄/诊断/治疗Key words
Esophageal Stenosis/CN/Esophageal Stenosis/DI/Therapy引用本文复制引用
雷洪波,吴春,潘征夏,杨杰先,范颖..33例先天性食管狭窄的诊治分析[J].临床小儿外科杂志,2016,15(3):268-271,4.
