Benign esophageal strictures: about 13 operated cases

Estenosis esofágicas benignas: a propósito de 13 casos operados

Praderi, Luis A

Resumen:

A survey is carried out of a personal series of 13 cases of benign esophageal stenosis comprising, 8 diaphragmatic herniations, 1 cardiofundic malformation, 2 aclasias and 1 inferior esophageal membrane .. In 39 cases of hiatal herniations, 7 presented stenosis; in the reversible forms, only Nissen's funduplicature was used, with excellent results, due consideration being given to backflow upon ga,stric herniation. The irreversible forms were treated with cardioplasty of the HeinekeMiculicz type followed by Thal's appositionor funduplicature. Nissen's method is regarded as satisfactory for cardiofundic malformations and stenoses following failule of other procedures, such as Allison's.In cases of acalasia the Heller-Kole methods is advocated, but with angle repain in order to prevent the consequent backflow syndrome. The case of esophageal membrane is dealt with in detail, the writeh advising endoscopy at surgery in order to plot its height, followed by esophagotomy. 


Se analizan: etiopatogenia, diagnóstico y tratamiento quirúrgico de una serie personal de 13 casos de estenosis esofágicas benignas, que comprenden 8 hernias diafragmáticas,1 malformación cardiofúndica, 2 acalasias y 1 membrana esofágica inferior. En 39 casos de hernias hiatales, 7 presentaban estenosis; en las formas reversibles empleamos la funduplicatura de Nissen, solamente, con excelente resultado (se jerarquiza el reflujo sobre la herniación gástrica). Las formas irreversibles· fueron tratadas por cardioplastia tipo HeinekeMiculicz y luego aposición de Thal o funduplicatura. Se considera el método de Nissen como bueno para las malformaciones cardiofúndicas y las estenosis consecutivasa falla de otros procedimientos como el de Allison. En la acalasia se insiste en el método de Heller-Kole, pero reparando el ángulo para evitar el síndrome de reflujo consecutivo. El caso de membrana esofágica se analiza en detalle y se aconseja la endoscopia intraoperatoria para topografiar su altura y luego la resección por esofagotomía con buen resultado.


Detalles Bibliográficos
2020
esófago
enfermedades del esófago
cirugía
esophagus
esophagus diseases
surgery
Español
Sociedad de Cirugía del Uruguay
Revista Cirugía del Uruguay
https://revista.scu.org.uy/index.php/cir_urug/article/view/2011
Acceso abierto
Resumen:
Sumario:A survey is carried out of a personal series of 13 cases of benign esophageal stenosis comprising, 8 diaphragmatic herniations, 1 cardiofundic malformation, 2 aclasias and 1 inferior esophageal membrane .. In 39 cases of hiatal herniations, 7 presented stenosis; in the reversible forms, only Nissen's funduplicature was used, with excellent results, due consideration being given to backflow upon ga,stric herniation. The irreversible forms were treated with cardioplasty of the HeinekeMiculicz type followed by Thal's appositionor funduplicature. Nissen's method is regarded as satisfactory for cardiofundic malformations and stenoses following failule of other procedures, such as Allison's.In cases of acalasia the Heller-Kole methods is advocated, but with angle repain in order to prevent the consequent backflow syndrome. The case of esophageal membrane is dealt with in detail, the writeh advising endoscopy at surgery in order to plot its height, followed by esophagotomy.