目的：探讨胃镜全程直视引导食管沙氏扩张探条扩张治疗高位食管癌术后吻合口狭窄的临床应用价值。方法50例高位食管癌术后吻合口狭窄病例随机分为2组各25例，一组为对照组，行非全程胃镜引导下的食管扩张术，另一组为观察组，行全程胃镜下引导的食管扩张术，并对上述两组病例在操作成功率、扩张后食管腔直径增大值等指标进行比较分析。结果对照组扩张成功率为84.00%，观察组扩张成功率为96.00%，明显高于对照组（P<0.05）。研究显示在24例全程胃镜引导下的食管扩张术可使食管直径增大（6.7±1.3）mm，而21例非全程胃镜引导下的食管扩张术可使食管直径增大（4.1±1.1）mm，两组食管腔直径增大值比较差异显著（P<0.05）。结论在高位食管吻合术后吻合口狭窄的扩张治疗中，全程胃镜下引导的食管扩张术可以直视扩张部位进行操作，方法较传统的非全程胃镜引导下的食管扩张术的更具优势。%Objective To explore the clinical value of dilation therapy with Savary-Gilliard dilator under whole direct-viewing endoscope for anastomotic stricture due to post-operative carcinoma of the upper esophagus. Methods Fifty patients with anastomotic stricture due to post-operative carcinoma of the upper esophagus were randomly divided into two groups: one group patients underwent esophageal dilatation under non-whole direct-viewing endoscope as control, another group patients underwent esophageal dilatation under whole direct-viewing endoscope as treatment group. The dilation success rate and increment value of intrae-sophageal diameter were compared and analyzed. Results Success rate of dilatation was 84.00%in control group, while 96.00%in treatment (P<0.05). The increment value of intraesophageal diameter was (4.1 ± 1.1) mm in control group, while (6.7 ± 1.3) mm in treatment group (P < 0.05). Conclusion In the therapy with Savary-Gilliard dilator under whole direct-viewing endoscope for anastomotic stricture due to post-operative carcinoma of the upper esophagus, the dilatation site could be directly observed and operated. This method was better than traditional esophageal dilatation.
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