腐食性食道炎による瘢痕性食道狭窄に対する有茎空腸間置食道再建術の経験
アルカリ誤飲による腐食性食道炎後の瘢痕性食道狭窄に対し，食道切除および有茎空腸間置による食道再建術を施行した．症例は4 歳と1 歳6 か月の幼児で，いずれも保存的な食道拡張術が無効と判断し，それぞれ受傷後6 か月，11 か月で食道再建術を施行した．術後は2 例ともに頸部食道と間置空腸の吻合部狭窄のためバルーン拡張術を必要としたが，それぞれ術後3 か月，5 か月目に普通食の摂取が可能となり，以後，経過は良好である． 腐食性食道炎による瘢痕性食道狭窄に対する有茎空腸間置食道再建術は安全に実施可能で，かつ良好な蠕動とそれに伴う食物輸送能を維持した再建術式である．本術式の施行に際しては，術前の諸検査に...
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| Published in | 日本小児外科学会雑誌 Vol. 49; no. 4; pp. 939 - 947 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本小児外科学会
20.06.2013
日本小児外科学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0288-609X 2187-4247 |
| DOI | 10.11164/jjsps.49.4_939 |
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| Abstract | アルカリ誤飲による腐食性食道炎後の瘢痕性食道狭窄に対し，食道切除および有茎空腸間置による食道再建術を施行した．症例は4 歳と1 歳6 か月の幼児で，いずれも保存的な食道拡張術が無効と判断し，それぞれ受傷後6 か月，11 か月で食道再建術を施行した．術後は2 例ともに頸部食道と間置空腸の吻合部狭窄のためバルーン拡張術を必要としたが，それぞれ術後3 か月，5 か月目に普通食の摂取が可能となり，以後，経過は良好である． 腐食性食道炎による瘢痕性食道狭窄に対する有茎空腸間置食道再建術は安全に実施可能で，かつ良好な蠕動とそれに伴う食物輸送能を維持した再建術式である．本術式の施行に際しては，術前の諸検査による最適な吻合部位の判断，間置空腸脚の血管茎の十分な確保，術後吻合部狭窄を認めた際の適切な処置などが特に重要と思われた． |
|---|---|
| AbstractList | 「要旨」アルカリ誤飲による腐食性食道炎後の瘢痕性食道狭窄に対し, 食道切除および有茎空腸間置による食道再建術を施行した. 症例は4歳と1歳6か月の幼児で, いずれも保存的な食道拡張術が無効と判断し, それぞれ受傷後6か月, 11か月で食道再建術を施行した. 術後は2例ともに頸部食道と間置空腸の吻合部狭窄のためバルーン拡張術を必要としたが, それぞれ術後3か月, 5か月目に普通食の摂取が可能となり, 以後, 経過は良好である. 腐食性食道炎による瘢痕性食道狭窄に対する有茎空腸間置食道再建術は安全に実施可能で, かつ良好な蠕動とそれに伴う食物輸送能を維持した再建術式である. 本術式の施行に際しては, 術前の諸検査による最適な吻合部位の判断, 間置空腸脚の血管茎の十分な確保, 術後吻合部狭窄を認めた際の適切な処置などが特に重要と思われた. アルカリ誤飲による腐食性食道炎後の瘢痕性食道狭窄に対し，食道切除および有茎空腸間置による食道再建術を施行した．症例は4 歳と1 歳6 か月の幼児で，いずれも保存的な食道拡張術が無効と判断し，それぞれ受傷後6 か月，11 か月で食道再建術を施行した．術後は2 例ともに頸部食道と間置空腸の吻合部狭窄のためバルーン拡張術を必要としたが，それぞれ術後3 か月，5 か月目に普通食の摂取が可能となり，以後，経過は良好である． 腐食性食道炎による瘢痕性食道狭窄に対する有茎空腸間置食道再建術は安全に実施可能で，かつ良好な蠕動とそれに伴う食物輸送能を維持した再建術式である．本術式の施行に際しては，術前の諸検査による最適な吻合部位の判断，間置空腸脚の血管茎の十分な確保，術後吻合部狭窄を認めた際の適切な処置などが特に重要と思われた． |
| Author | 鈴木, 信 藤野, 順子 鈴木, 則夫 黒岩, 実 石丸, 由紀 畑中, 政博 五十嵐, 昭宏 田原, 和典 池田, 均 青木, 真理子 |
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| References | 30) Saeki M, Tsuchida Y, Ogata T, et al: Long-term results of jejunal replacement of the esophagus. J Pediatr Surg, 23: 483-489, 1988. 2) Huang YC, Ni YH, Lai HS, et al: Corrosive esophagitis in children. Pediatr Surg Int, 20: 207-210, 2004. 18) Zhou JH, Jiang YG, Wang RW, et al: Management of corrosive esophageal burns in 149 cases. J Thorac Cardiovasc Surg, 130: 449-455, 2005. 26) Ascioti AJ, Hofstetter WL, Miller MJ, et al: Longsegment, supercharged, pedicled jejunal flap for total esophageal reconstruction. J Thorac Cardiovasc Surg, 130: 1391-1398, 2005. 5) Miller H, Lam KH, Ong GB: Observations of pressure waves in stomach, jejunal, and colonic loops used to replace the esophagus. Surgery, 78: 543-551, 1975. 25) Cauchi JA, Buick RG, Gornall P, et al: Oesophageal substitution with free and pedicled jejunum: Short- and long-term outcomes. Pediatr Surg Int, 23: 11-19, 2007. 4) Calleja IJ, Moreno E, Santoyo J, et al: Long esophagoplasty: Functional study. Hepatogastroenterology, 35: 279-284, 1988. 10) Kiviranta UK: Corrosion carcinoma of the esophagus; 381 cases of corrosion and nine cases of corrosion carcinoma. Acta Otolaryngol, 42: 89-95, 1952. 19) Han Y, Cheng QS, Li XF, et al: Surgical management of esophageal strictures after caustic burns: A 30 years of experience. World J Gastroenterol, 10: 2846-2849, 2004. 8) Appelqvist P, Salmo M: Lye corrosion carcinoma of the esophagus: A review of 63 cases. Cancer, 45: 2655- 2658, 1980. 3) Millar AJ, Numanoglu A, Rode H: Caustic strictures of the esophagus. In Grosfeld JL, O'Neill JA, Fonkalsrud EW, et al (ed): Pediatric Surgery (5th ed). pp 1082-1092, Mosby, St Louis, 1998. 13) Oakes DD, Sherck JP, Mark JB: Lye ingestion. Clinical patterns and therapeutic implications. J Thorac Cardiovasc Surg, 83: 194-204, 1982. 22) Bonavina L, Anselmino M, Ruol A, et al: Functional evaluation of the intrathoracic stomach as an oesophageal substitute. Br J Surg, 79: 529-532, 1992. 16) Chattopadhyay TK, Kapoor VK, Gupta S: The management of extensive corrosive esophageal strictures: Do not dilate and procrastinate. Jpn J Surg, 19: 171- 176, 1989. 21) Sutton R, Sutton H, Ackery DM, et al: Functional assessment of colonic interposition with 99Tcm-labeled milk. J Pediatr Surg, 24: 874-881, 1989. 28) Cusick EL, Batchelor AA, Spicer RD: Development of a technique for jejunal interposition in long-gap esophageal atresia. J Pediatr Surg, 28: 990-994, 1993. 15) 小泉博義：損傷および異物．出月康夫，他編：新外科学大系 食道の外科．中山書店，東京，1988 14) Erdogan E, Emir H, Eroglu E, et al: Esophageal replacement using the colon: A 15-year review. Pediatr Surg Int, 16: 546-549, 2000. 20) Hamza AF, Abdelhay S, Sherif H, et al: Caustic esophageal strictures in children: 30 years' experience. J Pediatr Surg, 38: 828-833, 2003. 17) Arul GS, Parikh D: Oesophageal replacement in children. Ann R Coll Surg Engl, 90: 7-12, 2008. 29) Ring WS, Varco RL, L'Heureux PR, et al: Esophageal replacement with jejunum in children: An 18 to 33 year follow-up. J Thorac Cardiovasc Surg, 83: 918-927, 1982. 31) Nederlof N, Tilanus HW, Tran TC, et al: End-toend versus end-to-side esophagogastrostomy after esophageal cancer resection: A prospective randomized study. Ann Surg, 254: 226-233, 2011. 7) de Jong AL, Macdonald R, Ein S, et al: Corrosive esophagitis in children: A 30-year review. Int J Pediatr Otorhinolaryngol, 57: 203-211, 2001. 11) Morikawa N, Honna T, Kuroda T, et al: High dose intravenous methylprednisolone resolves esophageal stricture resistant to balloon dilatation with intralesional injection of dexamethasone. Pediatr Surg Int, 24: 1161- 1164, 2008. 6) 鈴木 信，石丸由紀，田原和典，他：腐食性食道炎後の二次性食道狭窄に対する外科治療．小児外科，42: 1313-1317, 2010. 12) Rothstein FC: Caustic injuries to the esophagus in children. Pediatr Clin North Am, 33: 665-674, 1986. 23) Bax NM, van der Zee DC: Jejunal pedicle grafts for reconstruction of the esophagus in children. J Pediatr Surg, 42: 363-369, 2007. 9) Kochhar R, Sethy PK, Kochhar S, et al: Corrosive induced carcinoma of esophagus: Report of three patients and review of literature. J Gastroenterol Hepatol, 21: 777-780, 2006. 24) Maier A, Pinter H, Tomaselli F, et al: Retrosternal pedicled jejunum interposition: An alternative for reconstruction after total esophago-gastrectomy. Eur J Cardiothorac Surg, 22: 661-665, 2002. 1) Spitz L, Lakhoo K: Caustic ingestion. Arch Dis Child, 68: 157-158, 1993. 27) Chana JS, Chen HC, Sharma R, et al: Microsurgical reconstruction of the esophagus using supercharged pedicled jejunum flaps: Special indications and pitfalls. Plast Reconstr Surg, 110: 742-748; discussion 749- 750, 2002. |
| References_xml | – reference: 24) Maier A, Pinter H, Tomaselli F, et al: Retrosternal pedicled jejunum interposition: An alternative for reconstruction after total esophago-gastrectomy. Eur J Cardiothorac Surg, 22: 661-665, 2002. – reference: 22) Bonavina L, Anselmino M, Ruol A, et al: Functional evaluation of the intrathoracic stomach as an oesophageal substitute. Br J Surg, 79: 529-532, 1992. – reference: 30) Saeki M, Tsuchida Y, Ogata T, et al: Long-term results of jejunal replacement of the esophagus. J Pediatr Surg, 23: 483-489, 1988. – reference: 10) Kiviranta UK: Corrosion carcinoma of the esophagus; 381 cases of corrosion and nine cases of corrosion carcinoma. Acta Otolaryngol, 42: 89-95, 1952. – reference: 7) de Jong AL, Macdonald R, Ein S, et al: Corrosive esophagitis in children: A 30-year review. Int J Pediatr Otorhinolaryngol, 57: 203-211, 2001. – reference: 14) Erdogan E, Emir H, Eroglu E, et al: Esophageal replacement using the colon: A 15-year review. Pediatr Surg Int, 16: 546-549, 2000. – reference: 5) Miller H, Lam KH, Ong GB: Observations of pressure waves in stomach, jejunal, and colonic loops used to replace the esophagus. Surgery, 78: 543-551, 1975. – reference: 18) Zhou JH, Jiang YG, Wang RW, et al: Management of corrosive esophageal burns in 149 cases. J Thorac Cardiovasc Surg, 130: 449-455, 2005. – reference: 3) Millar AJ, Numanoglu A, Rode H: Caustic strictures of the esophagus. In Grosfeld JL, O'Neill JA, Fonkalsrud EW, et al (ed): Pediatric Surgery (5th ed). pp 1082-1092, Mosby, St Louis, 1998. – reference: 16) Chattopadhyay TK, Kapoor VK, Gupta S: The management of extensive corrosive esophageal strictures: Do not dilate and procrastinate. Jpn J Surg, 19: 171- 176, 1989. – reference: 20) Hamza AF, Abdelhay S, Sherif H, et al: Caustic esophageal strictures in children: 30 years' experience. J Pediatr Surg, 38: 828-833, 2003. – reference: 29) Ring WS, Varco RL, L'Heureux PR, et al: Esophageal replacement with jejunum in children: An 18 to 33 year follow-up. J Thorac Cardiovasc Surg, 83: 918-927, 1982. – reference: 2) Huang YC, Ni YH, Lai HS, et al: Corrosive esophagitis in children. Pediatr Surg Int, 20: 207-210, 2004. – reference: 19) Han Y, Cheng QS, Li XF, et al: Surgical management of esophageal strictures after caustic burns: A 30 years of experience. World J Gastroenterol, 10: 2846-2849, 2004. – reference: 11) Morikawa N, Honna T, Kuroda T, et al: High dose intravenous methylprednisolone resolves esophageal stricture resistant to balloon dilatation with intralesional injection of dexamethasone. Pediatr Surg Int, 24: 1161- 1164, 2008. – reference: 25) Cauchi JA, Buick RG, Gornall P, et al: Oesophageal substitution with free and pedicled jejunum: Short- and long-term outcomes. Pediatr Surg Int, 23: 11-19, 2007. – reference: 26) Ascioti AJ, Hofstetter WL, Miller MJ, et al: Longsegment, supercharged, pedicled jejunal flap for total esophageal reconstruction. J Thorac Cardiovasc Surg, 130: 1391-1398, 2005. – reference: 6) 鈴木 信，石丸由紀，田原和典，他：腐食性食道炎後の二次性食道狭窄に対する外科治療．小児外科，42: 1313-1317, 2010. – reference: 12) Rothstein FC: Caustic injuries to the esophagus in children. Pediatr Clin North Am, 33: 665-674, 1986. – reference: 27) Chana JS, Chen HC, Sharma R, et al: Microsurgical reconstruction of the esophagus using supercharged pedicled jejunum flaps: Special indications and pitfalls. Plast Reconstr Surg, 110: 742-748; discussion 749- 750, 2002. – reference: 23) Bax NM, van der Zee DC: Jejunal pedicle grafts for reconstruction of the esophagus in children. J Pediatr Surg, 42: 363-369, 2007. – reference: 1) Spitz L, Lakhoo K: Caustic ingestion. Arch Dis Child, 68: 157-158, 1993. – reference: 28) Cusick EL, Batchelor AA, Spicer RD: Development of a technique for jejunal interposition in long-gap esophageal atresia. J Pediatr Surg, 28: 990-994, 1993. – reference: 9) Kochhar R, Sethy PK, Kochhar S, et al: Corrosive induced carcinoma of esophagus: Report of three patients and review of literature. J Gastroenterol Hepatol, 21: 777-780, 2006. – reference: 13) Oakes DD, Sherck JP, Mark JB: Lye ingestion. Clinical patterns and therapeutic implications. J Thorac Cardiovasc Surg, 83: 194-204, 1982. – reference: 31) Nederlof N, Tilanus HW, Tran TC, et al: End-toend versus end-to-side esophagogastrostomy after esophageal cancer resection: A prospective randomized study. Ann Surg, 254: 226-233, 2011. – reference: 15) 小泉博義：損傷および異物．出月康夫，他編：新外科学大系 食道の外科．中山書店，東京，1988． – reference: 8) Appelqvist P, Salmo M: Lye corrosion carcinoma of the esophagus: A review of 63 cases. Cancer, 45: 2655- 2658, 1980. – reference: 17) Arul GS, Parikh D: Oesophageal replacement in children. Ann R Coll Surg Engl, 90: 7-12, 2008. – reference: 4) Calleja IJ, Moreno E, Santoyo J, et al: Long esophagoplasty: Functional study. Hepatogastroenterology, 35: 279-284, 1988. – reference: 21) Sutton R, Sutton H, Ackery DM, et al: Functional assessment of colonic interposition with 99Tcm-labeled milk. J Pediatr Surg, 24: 874-881, 1989. |
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| Snippet | アルカリ誤飲による腐食性食道炎後の瘢痕性食道狭窄に対し，食道切除および有茎空腸間置による食道再建術を施行した．症例は4 歳と1 歳6 か月の幼児で，いずれも保存的な... 「要旨」アルカリ誤飲による腐食性食道炎後の瘢痕性食道狭窄に対し, 食道切除および有茎空腸間置による食道再建術を施行した. 症例は4歳と1歳6か月の幼児で, いずれも保存... |
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| SubjectTerms | アルカリ誤飲 有茎空腸間置術 瘢痕性食道狭窄 腐食性食道炎 食道再建術 |
| Title | 腐食性食道炎による瘢痕性食道狭窄に対する有茎空腸間置食道再建術の経験 |
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| ispartofPNX | 日本小児外科学会雑誌, 2013/06/20, Vol.49(4), pp.939-947 |
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