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食管 Barretts 溃疡常因有发生穿孔、出血、狭窄、恶变等潜在危险而主张手术治疗,然而早就有作者指出,大部分 Barrett’s 溃疡可经内科治疗而愈合,且不留有后遗症,这些作者认为,不加区别地动辄采用手术治疗是不适宜的;可惜多年来对这一点尚未成为共识。为此,作者复习了 Lahey 临床自1973～1990年17年间治疗285例食管 Barrett’s 病的经验,对其中经内窥镜检查严格符合 Allison-Johnstone 诊断标准的30例 Barrett’s 溃疡进行了分析,以期总结出究竟哪些情况下才适宜手术治疗。常见症状包括胸骨后烧灼感、吞咽困难、出血、贫血等、内窥镜下所见的溃疡大小在0.5～3 cm 之间,其中60%在1 cm 左右,19例并同时作溃疡周边多处活检。确诊后即予积极的
Esophageal Barretts can often be considered surgically because of the potential risk of perforation, bleeding, stenosis, malignancy, etc. However, it has long been pointed out by authors that the majority of Barrett’s ulcers can be surgically cured without sequelae. According to the authors, Indiscriminate surgical treatment indiscriminately is not appropriate; unfortunately, this has not been the consensus for many years. To this end, the authors reviewed the clinical experience of Lahey’s clinical treatment of 285 cases of Barrett’s disease in esophagus from 1973 to 1990, and analyzed 30 Barrett’s ulcers endoscopically consistent with the Allison-Johnstone diagnostic criteria for the purpose of summarizing In what circumstances is suitable for surgical treatment. Common symptoms include sternal burning sensation, dysphagia, hemorrhage, anemia and so on. The size of ulcer seen in endoscopy is between 0.5 cm and 3 cm, of which 60% is about 1 cm. In 19 cases, multiple ulcers Biopsy. After the diagnosis is positive