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Laparoscopic retrosternal bypass for corrosive stricture of the esophagus

机译：腹腔镜胸骨后旁路治疗食管腐蚀狭窄

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Introduction: Surgical management of corrosive stricture of the esophagus entails replacement of the scarred esophagus with a gastric or colonic conduit. This has traditionally been done using the conventional open surgical approach. We herein describe the first ever reported minimally invasive technique for performing retrosternal esophageal bypass using a stomach conduit. Methods: Patients with corrosive stricture involving the esophagus alone with a normal stomach were selected. The surgery was performed with the patient in supine position using four abdominal ports and a transverse skin crease neck incision. Steps included mobilization of the stomach and division of the gastroesophageal junction, creation of a retrosternal space, transposition of stomach into the neck (via retrosternal space), and a cervical esophagogastric anastomosis. Results: Four patients with corrosive stricture of the esophagus underwent this procedure. The average duration of surgery was 260 (240-300) min. All patients could be ambulated on the first postoperative day and were allowed oral liquids between the fifth and seventh day. At mean follow-up of 6.5 (3-9) months, all are euphagic to solid diet and have excellent cosmetic results. Conclusions: Laparoscopic bypass for corrosive stricture of the esophagus using a gastric conduit is technically feasible. It results in early postoperative recovery, effective relief of dysphagia, and excellent cosmesis in these young patients.
机译：简介：食管腐蚀性狭窄的外科手术处理需要用胃或结肠导管置换瘢痕性食道。传统上，这是使用常规的开放式手术方法完成的。我们在此描述了有史以来第一个使用胃导管进行胸骨后食管旁路手术的微创技术。方法：选择仅患有食管且胃部正常的腐蚀性狭窄患者。手术是在患者仰卧位使用四个腹部端口和横向皮肤皱纹颈部切口进行的。步骤包括动员胃部和胃食管连接处的分割，胸骨后腔的建立，胃向颈部的移位（通过胸骨后腔）的移位以及宫颈食管胃吻合术。结果：4例食管腐蚀狭窄患者接受了该手术。平均手术时间为260（240-300）分钟。所有患者可以在术后第一天走动，并在第五天到第七天之间口服液体。平均随访6.5（3-9）个月，所有患者均对固体饮食感到满意，并具有出色的美容效果。结论：腹腔镜旁路使用胃导管对食道进行腐蚀性狭窄在技术上是可行的。在这些年轻患者中，它可导致术后早期恢复，吞咽困难的有效缓解以及出色的美容效果。

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