A型食道閉鎖 (Long Gap 症例) に対する Spiral Myotomy の経験

概要

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A case of long-gap esophageal atresia (Gross A type) was presented, in which an end-to-end anastomosis was successfully established by a combination of esophageal elongation technique and "spiral esophagomyotomy". Advantages from this spiral myotomy are as follows: 1) In circular myotomy the amuscular segment often becomes dilates with time, forming diverticulum. In spiral myotomy, on the contrary, the diameter of the myotomized portion becomes smaller due to a torsion effect along the spiral incision caused by a downward stretching of the upper pouch, preventing diverticular dilatation. 2) By addition of the torsion, the diameter of the dilated upper pouch diminishes, making an anastomosis between the upper and the lower pouch more feasible. 3) Networks of nervous and vascular systems do not seem to be impaired so much in the spiral incision as in circular myotomy.
日本小児外科学会の論文
1988-02-20