양성식도질환에서 식도절제 경험

Abstract

Background: Benign esophageal diseases are less common indications for an esophagectomy. The indications for an esophagectomy have not been clearly defined for benign esophageal diseases. The purpose of this study was to defermine whether an esophagectomy should be performed for benign esophageal disease and the indications for an esophagectomy. Methods: The postoperative morbidity and mortality were examined in 11 patients who had received esophagectomy and esophageal reconstruction for benign esophageal diseases between 1981 and 1996 in this hospital. The indications were identified. Results: The indications included corrosive stricture (6 cases), recurrent achalasia (2 cases), accidental esophageal perforation (1 case), a esophageal diverticulum with stricture (1 case) and suspicion of malignancy (1 case). All of the patients with recurrent achalasia had undergone at least one prior esophageal operation, and all of the patients with stricture had had at least one esophageal dilation previouly. There was no postoperative mortality after the esohagectomies. Postoperative complications developed in 7 patients. Early complications were anastomotic leakage (3 cases), bronchopneumonia (1 case) and DIC ARDS (1 case). Later complications were intestinal obstruction (1 case), anastomotic bleeding (1 case) and anastomotic stenosis (4 cases) which needed one or two dilation procedures to improve the symptoms. Conclusion: Although an esophagectomy for benign esophageal diseases resulted in high morbidity, there were no mortalities. Thus, an esophagectomy should be considered for benign conditions of the esophagus because of corrosive cancer and the end-stage of motility disorders.