咽食管憩室的外科治疗-6例报道及文献复习

摘要

Objective To improve the standards of diagnosis and treatment of pharyngoesophageal diverticulum. Methods 6 cases of pharyngoesophageal diverticulum admitted from 1987 to 1999 were analysed retrospectively.Discussion was made in related with the literature. Results All of the 6 cases were male, which had been diagnosed by the esophagram and/or fiber esophagoscopy. Diverticulectomy with cricopharyngeus myotomy was performed in 4 of the 6 cases, and the results were satisfied. The other two were multiple esophageal diverticula, which had developed an esophageal squamous cell carcinoma and a cardiac adenocarcinoma respectively. So, carcinomectomy and esophagogastroanastomosis were performed. One of them was missed thirteen years after operation,the other case died of metastasis 34 months after operation. Conclusion Diverticulectomy with cricopharyngeus myotomy is a better operation in the treatment of pharyngoesophageal diverticulum. Endoscopic diverticulectomy is the developing tendency. It is necessary to give a long－ term follow－ up of this condition.%目的提高咽食管憩室的诊治水平。方法对 1987～ 1999年收治的 6例咽食管憩室进行回顾性分析并结合有关文献进行了讨论。结果 6例均为男性，均经食管钡餐造影或 /和纤维食管镜检查确诊。其中 4例单纯憩室行憩室切除＋环咽肌切开术，疗效满意。 2例多发性憩室分别并发食管鳞状细胞癌和贲门腺癌，均进行癌切除与食管胃吻合术， 1例术后生存 13年后失访，另 1例术后生存 2年 10个月癌复发转移死亡。结论咽食管憩室的手术方法以憩室切除＋环咽肌切开术为佳。内镜下治疗是发展方向。对本病的长期随防是必要的。