Heba Taher, Ahmed Amgad, Andrew Magdi, Ahmed Magdy, Hytham Esmate El Tantawi, Sherif N Kaddah, Sherifa Tawfik, Mahmoud Tarek, Khaled S Abdullateef
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引用次数: 0
Abstract
Purpose: This study evaluates the outcomes of transhiatal colon bypass, with or without esophagectomy, as a surgical intervention for esophageal replacement in pediatric patients with severe corrosive esophageal strictures, focusing on safety, complications, and long-term functional outcomes.
Materials and methods: A retrospective analysis was conducted on pediatric patients who underwent transhiatal colon bypass between 2016 and 2019. The study included cases both with and without simultaneous esophagectomy. Standardized follow-up protocols were used to monitor complications, mortality, and long-term outcomes.
Results: Ten pediatric patients were included, with seven undergoing esophagectomy as part of the transhiatal colon bypass. The esophagectomy group had a significantly longer operative time (6.0 ± 0.7 h vs. 5.0 ± 0.4 h, p = 0.02). Intraoperative complications included vagus nerve injury (2 cases) and one intraoperative death. Postoperative issues included pneumonia (2 cases) and anastomotic leaks (2 cases). Long-term complications included anastomotic strictures and one case of intestinal obstruction. Despite these complications, both groups showed normal growth and good functional outcomes, with no significant differences in manometric results (p = 1.00).
Conclusion: Transhiatal colon bypass is a safe and effective option for esophageal replacement in pediatric patients with corrosive esophageal strictures. While esophagectomy increases surgical complexity and risks, it may be necessary in cases where the native esophagus poses long-term risks. Intraoperative assessment is crucial in deciding whether to include esophagectomy.
目的:本研究评估经裂口结肠旁路术(伴或不伴食管切除术)作为严重腐蚀性食管狭窄患儿食管置换术的手术干预的结果,重点关注安全性、并发症和长期功能结局。材料与方法:回顾性分析2016 - 2019年行经裂口结肠旁路手术的儿童患者。该研究包括同时进行食管切除术和不同时进行食管切除术的病例。标准化随访方案用于监测并发症、死亡率和长期预后。结果:纳入10例儿童患者,其中7例接受食管切除术作为经裂口结肠旁路术的一部分。食管切除术组手术时间明显延长(6.0±0.7 h vs. 5.0±0.4 h, p = 0.02)。术中并发症包括迷走神经损伤2例,术中死亡1例。术后并发症包括肺炎2例,吻合口漏2例。长期并发症包括吻合口狭窄和1例肠梗阻。尽管有这些并发症,两组均表现出正常的生长和良好的功能结果,测压结果无显著差异(p = 1.00)。结论:经裂孔结肠旁路术是一种安全有效的治疗腐蚀性食管狭窄的方法。虽然食管切除术增加了手术的复杂性和风险,但在天然食管存在长期风险的情况下可能是必要的。术中评估是决定是否包括食管切除术的关键。
期刊介绍:
Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.