治療成績からみた逆流性食道炎の特徴―外科的治療法から

Cases of Resistance to Surgical Procedure for Reflux Esophagitis

要旨　逆流性食道炎に外科的治療を行った症例の成績について内視鏡所見を中心に述べた．食道裂孔ヘルニアで手術施行した37例のうち逆流性食道炎を伴っていた症例は15例で，これらについて術前内視鏡所見と術後の経過について比較した．逆流性食道炎再発例における術前内視鏡所見はgrade 4の症例のうち潰瘍・狭窄を伴った症例であった．再発した2症例は慢性関節リウマチの既往があったが，本疾患との因果関係は不明である．再発時期は術後1年半から3年で，再発後は保存的治療で経過観察している．一方，術前grade 4でも狭窄・潰瘍のみられないような症例では，腹腔鏡下噴門部形成術で軽快治癒しているが，長期成績については今後の課題と考えられた．

　Out of 37 cases of esophageal hernia, which were treated by operation, fifteen were reviewed concerning preoperative and post operative endoscopic findings. Out of 15 cases, two were cases to recidivistic reflux esophagitis after operation. In these cases, the preoperative endoscopic findings revealed ulcer and stricture. It was also noted that these two cases had experienced chronic rheumatism. It was not clear whether or not there was a causal relationships between the reflux esophagitis and rheumatism. In other cases, even those of grade 4 reflux esophagitis, an excellent result was obtained by surgical procedure.