手术治疗内镜取石失败后食管结石病例报告及文献复习  

Case report and literature review of surgical management of esophageal calculus after failed endoscopic stone removal

作　　者：张鑫平 宋帅[1] 常栋[1] Zhang Xinping;Song Shuai;Chang Dong(Department of Thoracic Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院胸外科,北京100050

出　　处：《国际外科学杂志》2022年第11期765-768,F0004,共5页International Journal of Surgery

摘　　要：目的探讨巨大食管结石的临床特点及治疗策略。方法回顾性分析首都医科大学附属北京友谊医院收治的1例内镜取石治疗失败后行开胸手术取石的食管结石患者的病例资料,并结合相关文献资料进行分析总结。结果该患者吞咽困难症状明显,严重营养不良,需进一步医疗干预。CT检查发现,食管下段巨大结石嵌顿,胃镜检查可见结石阻塞管腔,结石下方食管息肉及肌桥形成,因结石巨大且坚硬,多次内镜下取石失败,后经由胸外科行开胸手术成功取出结石。患者术后恢复良好,无吻合口漏及狭窄等并发症。结论食管结石形成后易引起食管梗阻,严重者甚至导致穿孔,因此临床上应积极处理。对于多次内镜取石失败的食管结石患者,开胸手术取石可作为进一步的治疗方法之一。Objective To investigate the clinical characteristics and therapeutic strategies of huge esophageal stones.Methods One patient with esophageal esophageal calculus admitted to Beijing Friendship Hospital,Capital Medical University,who failed in undergoing endoscope treatment and shifted to an operation were retrospectively analyzed,and analyzed and summarized in combination with relevant literature.Results The patient has significant dysphagia and severe malnutrition requiring further medical intervention.CT examination found that the lower esophagus was incarcerated with huge stones,and gastroscopy showed stones were obstructing the lumen,esophageal polyps and muscle bridges under the stones.Because the stones were large and hard,multiple endoscopic stone removal failed,and then the stones were successfully removed by thoracic surgery.The patient recovered well after surgery and had no complications such as anastomotic leakage or stenosis.Conclusions Esophageal stones are easy to cause obstruction,and even lead to perforation,so it should be actively managed clinically.For patients with esophageal stones who have failed multiple endoscopic stone removals,thoracotomy can be used as a further treatment.

关 键 词：食管 结石 内镜检查 外科手术 

分 类 号：R655.4[医药卫生—外科学]