A Study of Surgical Treatment for Corrosive Stircture of the Esophagus
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概要
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The pathological state of corrosive strictures of the esophagus differs in each clinical case depending on the nature and quantity of agents ingested and the mode of ingestion. Therefore, it is mandatory to take a suitable treatment that fits each case of corrosive strictures. For the reason that these strictures are not malignat in general, the authors have performed dilatation by bougienage or a by-pass operation in most cases.It should be noted, however, that carcinoma of the esophagus could occur secondary to corrosive stricture. Forty such cases have been reported in literature and two additional cases were also reported in Japan recently by Nakayama. The incidence of carcinoma of the esophagus has been claimed to be from 22 to 1, 000 times higher in the cases with corrosive stricture than in normal population.If the extent of corrosive stricture is limited or short, bougienage of the stricture is attempted as the first choice. When bougienage is found to be ineffective or the stricture is too extensive, srugical treatment should be considered. Considering the possibility of future development of malignancy at the site of corrosive legions, resection of the constricted portion of the esophagus is more desirable than a by-pass operation. Because of the fact that the procedure should be made from the prophylactic viewpoint, esophagectomy without thoracotomy-the so-called blunt dissection after Akiyama-is considered to be a reasonable and valuable approach. The authors operated one case using the same technique with successful result. Even in non-resected cases, a close long-term follow-up study should be made considering the possibility of later development of carcinoma.
- 特定非営利活動法人 日本気管食道科学会の論文
特定非営利活動法人 日本気管食道科学会 | 論文
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