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NEJM:一例关于食管胃旁路的案例报道

2016-04-21 MedSci MedSci原创

男性,60岁,以往进行过食管手术。  据了解,该患者在儿童时期曾因食道受到碱性烧伤,导致食管完全性狭窄。 在1962年(7岁),该患者接受了食管胃旁路手术(包括颈部食管结肠吻合术和腹内空肠结肠吻合术)。 体格检查发现,其胸部位置的近端食管胃旁路(结肠段)在腹部筋膜腹壁形成外突明显的疝。 吞水试验表明,该患者仍然具有正常的吞咽功能(请点击原始链接观看视频)。 会诊医师根据

男性,60岁,以往进行过食管手术。

 
据了解,该患者在儿童时期曾因食道受到碱性烧伤,导致食管完全性狭窄。

在1962年(7岁),该患者接受了食管胃旁路手术(包括颈部食管结肠吻合术和腹内空肠结肠吻合术)。

体格检查发现,其胸部位置的近端食管胃旁路(结肠段)在腹部筋膜腹壁形成外突明显的疝。

吞水试验表明,该患者仍然具有正常的吞咽功能(请点击原始链接观看视频)。

会诊医师根据该患者自身的情况,建议其进行疝修补术,但该患者出于对手术风险过大的担心,最终拒绝了手术治疗。

在过去,食管胃旁路术通常会被选择作为类似本案例中的病人进行治疗,因为这样病人可以避免发现其他的手术并发症和胸廓切开或胸骨后隧道术的麻醉。

目前,在临床上已经很少有直肠代食管,以及通过皮下定位食管替代术了。

原始出处:

Goran Marjanovic, M.D., and Jens Hoeppner, M.D. Esophagogastric Bypass in Motion

N Engl J Med 2016; 374:e20April 21, 2016



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    2016-09-16 1e10c84am36(暂无匿称)

    不错哦,会学到很多

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=128592, encodeId=60f6128592c9, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:51:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1934225, encodeId=8cdf1934225f0, content=<a href='/topic/show?id=72108319e63' target=_blank style='color:#2F92EE;'>#胃旁路#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83197, encryptionId=72108319e63, topicName=胃旁路)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Wed Dec 14 11:22:00 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82861, encodeId=421f828614f, content=可怕的图片, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0d231626576, createdName=jjzouyan, createdTime=Tue Apr 26 14:57:00 CST 2016, time=2016-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437117, encodeId=5dea143e117d4, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Apr 23 03:22:00 CST 2016, time=2016-04-23, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=128592, encodeId=60f6128592c9, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:51:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1934225, encodeId=8cdf1934225f0, content=<a href='/topic/show?id=72108319e63' target=_blank style='color:#2F92EE;'>#胃旁路#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83197, encryptionId=72108319e63, topicName=胃旁路)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Wed Dec 14 11:22:00 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82861, encodeId=421f828614f, content=可怕的图片, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0d231626576, createdName=jjzouyan, createdTime=Tue Apr 26 14:57:00 CST 2016, time=2016-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437117, encodeId=5dea143e117d4, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Apr 23 03:22:00 CST 2016, time=2016-04-23, status=1, ipAttribution=)]
    2016-04-26 jjzouyan

    可怕的图片

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=128592, encodeId=60f6128592c9, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:51:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1934225, encodeId=8cdf1934225f0, content=<a href='/topic/show?id=72108319e63' target=_blank style='color:#2F92EE;'>#胃旁路#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83197, encryptionId=72108319e63, topicName=胃旁路)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Wed Dec 14 11:22:00 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82861, encodeId=421f828614f, content=可怕的图片, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0d231626576, createdName=jjzouyan, createdTime=Tue Apr 26 14:57:00 CST 2016, time=2016-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437117, encodeId=5dea143e117d4, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Apr 23 03:22:00 CST 2016, time=2016-04-23, status=1, ipAttribution=)]
    2016-04-23 zhouqu_8

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