Clinical analysis of endoscopic therapy for esophageal anastomotic stricture

吴玥; 周雪; 陈瑶; 刘云杰; 彭贵勇

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Clinical analysis of endoscopic therapy for esophageal anastomotic stricture

更新时间：2026-01-09

- Clinical analysis of endoscopic therapy for esophageal anastomotic stricture
- Journal of Army Medical University Vol. 36, Issue 10, Pages: 1092-1097(2014)
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  CLC： R571.1;R768.2
- Published：2014
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吴玥,周雪,陈瑶,刘云杰,彭贵勇.内镜下不同治疗方案对食管吻合口狭窄的疗效分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(10):1092-1097.

　Wu Yue,Zhou Xue,Chen Yao,Liu Yunjie,Peng Guiyong.Clinical analysis of endoscopic therapy for esophageal anastomotic stricture[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(10):1092-1097.
吴玥,周雪,陈瑶,刘云杰,彭贵勇.内镜下不同治疗方案对食管吻合口狭窄的疗效分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(10):1092-1097. DOI：

　Wu Yue,Zhou Xue,Chen Yao,Liu Yunjie,Peng Guiyong.Clinical analysis of endoscopic therapy for esophageal anastomotic stricture[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(10):1092-1097. DOI：

摘要

目的探讨内镜下不同治疗方案对食管吻合口狭窄治疗的适应证及疗效。方法回顾性分析我院2008年1月至2013年6月104例食管吻合口狭窄接受不同内镜下治疗方案（内镜下球囊扩张术、微波凝固术、微波凝固联合球囊扩张术、球囊扩张术联合食管支架置入术以及微波凝固、球囊扩张联合支架置入术）的患者，从治疗间期、治疗总时间，治疗次数等方面分析不同治疗方案对各组食管吻合口狭窄的疗效及预后情况。结果 5种治疗方案均能在短期内有效缓解患者吞咽困难症状，术后1周吞咽困难评分均至少降低1分。5种治疗方案中，所需治疗次数＜5次者以球囊扩张术最多（86.67%），所需治疗次数＞10次者以微波、球囊联合支架置入治疗最多（41.18%）；最长治疗间隔时间不＜3个月比例最高的是球囊扩张治疗（80.0%），最小的是微波治疗（28.57%）；总疗程＞12个月比例最高的是微波球囊扩张序贯疗法（35.7%），最小的是球囊支架置入序贯疗法（4.8%）。结论根据食管吻合口狭窄发生部位、狭窄口最大直径及各种治疗方法的疗效不同，采用单一微波凝固术或球囊扩张术以及微波联合球囊扩张术、球囊联合支架置入术、微波+球囊联合支架置入术在发挥各单一治疗方案的优势的同时，在短期内缓解患者的吞咽困难、减少并发症的发生方面具有积极的意义。

Abstract

Objective To explore the indications and curative effect of the different endoscopic therapies for esophageal anastomotic stricture. Methods We retrospectively analyzed the treatment period

the total treatment time and the frequency of treatment in 104 cases who suffered from esophageal anastomotic stricture and accepted different endoscopic treatment options (balloon dilatation

electrocautery therapy

balloon dilatation combined with electrocautery therapy

balloon dilatation combined with stent implantation

and electrocautery and balloon dilatation combined with stent implantation) in our hospital from January 2008 to June 2013. Results In short term

all kinds of treatment programs could effectively relieve dysphagia

with the difficulty of swallow reducing by at least 1 point in 1 weak after treatment. For the proportion of patients who took one of the 5 kinds of treatment less than 5 times

the balloon dilatation group ranked first at 86.67%. For that more than 10 times

the group of electrocautery and balloon dilatation combined with stent implantation ranked first at 41.1%. For the proportion of patients whose treatment interval was longer than 4 months

the balloon dilatation group was the highest (80.0%) while the electrocautery group was the lowest (28.57%). For the proportion of patients whose total course of treatment was longer than 1 year

the balloon dilatation combined with electrocautery therapy group was the highest (35.7%) while the balloon dilatation combined with stent implantation group was the lowest (4.8%). Conclusion The appropriate treatment regimen according to the site and degree of esophageal anastomotic stricture and the treatment effect of balloon dilatation

electrocautery therapy

balloon dilatation combined with electrocautery therapy

balloon dilatation combined with stent implantation

and electrocautery and balloon dilatation combined with stent implantation helps decrease complications and improve the patients’ life quality.

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