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| 題 名 | Reconstruction of the Esophagus with a Long Segment of Jejunum=使用空腸來重建整段食道 |
|---|---|
| 作 者 | 黃敏雄; 徐中平; 乾光宇; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 18:4 1985.12[民74.12] |
| 頁 次 | 頁407-414 |
| 分類號 | 416.241 |
| 關鍵詞 | 空腸; 食道重建; |
| 語 文 | 英文(English) |
| 中文摘要 | 化學性食道的灼傷所引起食道狹窄,因為胃同時也常常受到傷害,通常需要大腸置換術(interposition of colon)來取代受灼傷之食道。但偶而因種種的因素而無法使用大腸時,亦可利用空腸來重建食道。本院在去年曾為3例此類的病患施行空腸置換術。第一例是一位意外吞食鹽酸的病患。使用左側大腸重建食道後病人進食良好。然手術後血管攝影檢查兩天後併發大腸壞死。故於一年後再以空腸重建食道。第二例是一位吞食鹽酸自殺的病患,因手術中意外的傷害到左側大腸動脈上昇枝,故改用空腸重建食道。術後頸部食道空腸吻合處發生輕微洩漏(minor leakage)。一週後洩漏處癒合良好,病人進食順利。第三例是一位吞食鹽酸自殺的病例。手術中因左側大腸動脈上昇枝受損,故改用空腸重建食道(即把空腸接到梨狀寶Pyriform sinus)。術後梨狀竇及空腸吻合處吻合良好。對上述食道重建發生困難的病例,空腸置換術是唯一解決病人進食困難的良策。特就榮總近一年來三例病患之經驗及手術方法提出報告。 |
| 英文摘要 | Dysphasia caused by acquired stricture of the esophagus from the ingestion of corrosives is relatively common. It is generally agreed that surgical reconstruction of the esophagus becomes essential if a satisfactory esophageal lumen can not be maintained by intermittent dilatations or other forms of conservative treatment. The esophagus should be reconstructed by interposition of a long segment of the colon; because the stomach is unsuitable as an esophageal substitute. In special circumstances, when the colon is not available, jejunum may have a place in reconstruction of the esophagus. This technique was used on three occasions during the past years. All three patients were victims of chemical corrosive injury of the esophagus. A long segment of jejunum was created. An esophagojejunostomy was performed above the stemal notch in two instances; in the other, a pharyngojejunostomy was done. Two cases were end-to-end anastomosis; the other was end-to-side. One case had minor leakage of the cervical anastomosis which healed completely without stenotic sequelae following a short period of total parenteral nutrition. |
本系統中英文摘要資訊取自各篇刊載內容。