目的 探討非惡性食管-氣管/支氣管瘺的臨床特點(diǎn)和處理方法?!》椒ā』仡櫺苑治?002年1月至2011年10月北京協(xié)和醫(yī)院收治12例非惡性食管-氣管/支氣管瘺患者的臨床資料,其中男6例, 女6例;平均年齡49.8 (32~72)歲。食管氣管瘺7例,食管支氣管瘺1例,食管癌術(shù)后胸胃支氣管瘺2例,食管憩室支氣管瘺2例。右側(cè)開胸入路9例,左側(cè)開胸3例。行食管瘺、氣管瘺修補(bǔ)7例;食管瘺、支氣管瘺修補(bǔ)1例;胸胃瘺、支氣管瘺修補(bǔ)術(shù)2例;食管下段、左肺下葉切除,食管胃弓下吻合術(shù)1例;左肺下葉切除,食管憩室瘺修補(bǔ)術(shù)1例?!〗Y(jié)果 全部患者均順利恢復(fù),無(wú)手術(shù)合并癥或死亡,7~10 d恢復(fù)經(jīng)口進(jìn)食。術(shù)后3個(gè)月~1年內(nèi)復(fù)查纖維支氣管鏡及上消化道造影,無(wú)氣管支氣管狹窄,無(wú)食管狹窄,不必采用支架或擴(kuò)張治療。術(shù)后隨診3個(gè)月~10年,均恢復(fù)良好?!〗Y(jié)論 食管-氣管/支氣管瘺排除惡性病因,明確瘺口位置, 術(shù)前給予充分營(yíng)養(yǎng)支持,手術(shù)Ⅰ期修補(bǔ)瘺口,可以獲得良好的治療效果。
引用本文: 郭峰,張志庸,崔玉尚,李力,李單青,徐曉輝. 非惡性食管-氣管/支氣管瘺的外科治療. 中國(guó)胸心血管外科臨床雜志, 2012, 19(5): 468-471. doi: 復(fù)制
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1. | Reed MF, Mathisen DJ. Tracheoesophageal fistula. Chest Surg Clin N Am, 2003, 13 (2):271-289. |
2. | Camargo JJ, Machuca TN, Camargo SM, et al. Surgical treatment of benign tracheo-oesophageal fistulas with tracheal resection and oesophageal primary closure: is the muscle flap really necessary?? Eur J Cardiothorac Surg,2010,37 (3):576-580. |
3. | Shen KR, Allen MS, Cassivi SD, et al. Surgical management of acquired nonmalignant tracheoesophageal and bronchoesophageal fistulae. Ann Thorac Surg ,2010, 90 (3):914-919. |
4. | Chappell VL, Heck Jr HA. Repair of large, iatrogenic, tracheo-esophageal fistulae. Ann Thorac Surg ,2007, 83 (2):705-706. |
5. | Bardini R, Radicchi V, Parimbelli P, et al. Repair of a recurrent benign tracheoesophageal fistula with a Gore-Tex membrane. Ann Thorac Surg, 2003, 76 (1):304-306. |
6. | Marzelle J, Dartevelle P, Khalife J, et al. Surgical management of acquired postintubation trachea-oesophageal fistulas: 27 patients. Eur J Cardiothorac Surg, 1989,3 (6):499-503. |
7. | Cherveniakov A, Tzekov C, Grigorov GE, et al. Acquired benign esophago-airway fistulas. Eur J Cardiothorac Surg, 1996, 10 (9):713-716. |
8. | Macchiarini P, Verhoye JP, Chapelier A, et al. Evaluation and outcome of different surgical techniques for postintubation tracheoesophageal fistulas. J Thorac Cardiovasc Surg, 2000, 119 (2):268-276. |
9. | Kovesi T, Rubin S. Long-term complications of congenital esophageal atresia and/or tracheoesophageal fistula. Chest, 2004, 126 (3):915-925. |
10. | 雷杰, 張娜, 駱晴, 等. 食管癌食管支氣管瘺的外科治療. 中國(guó)胸心血管外科臨床雜志, 2012, 19 (1):36-38. |
11. | Han Y, Liu K, Li X, et al. Repair of massive stent-induced tracheoesophageal fistula. J Thorac Cardiovasc Surg, 2009, 137 (4): 813-817. |
12. | Talbot ML, Hugh TB, Spratt P. Gastric antral patch oesophagoplasty for iatrogenic tracheo-oesophageal fistula. ANZ J Surg ,2007,77 (4):295-297. |
13. | Golash V. Single-stage repair of a large acquired tracheoesophageal fistula with interposition of 2 muscle pedicle flaps and laparoscopic gastrojejunostomy. J Thorac Cardiovasc Surg, 2006, 131 (6):1413-1414. |
14. | Schembre DB. Recent advances in the use of stents for esophageal disease. Gastrointest Endosc Clin N Am, 2010,20 (1):103-121. |
15. | Rabenstein T, Boosfeld C, Henrich R, et al. First use of ventricular septal defect occlusion device for endoscopic closure of an esophagorespiratory fistula using bronchoscopy and esophagoscopy. Chest, 2006,130 (3): 906-909. |
16. | Garand SA, Kareti LR, Dumont TM, et al. Thoracoscopic repair of tracheoesophageal fistula in a septuagenarian. Ann Thorac Surg, 2006, 81 (5):1899-1901. |
17. | Altorjay Á, Mucs M, Rüll M, et al. Recurrent, nonmalignant tracheoesophageal fistulas and the need for surgical improvisation. Ann Thorac Surg, 2010, 89 (6):1789-1796. |
- 1. Reed MF, Mathisen DJ. Tracheoesophageal fistula. Chest Surg Clin N Am, 2003, 13 (2):271-289.
- 2. Camargo JJ, Machuca TN, Camargo SM, et al. Surgical treatment of benign tracheo-oesophageal fistulas with tracheal resection and oesophageal primary closure: is the muscle flap really necessary?? Eur J Cardiothorac Surg,2010,37 (3):576-580.
- 3. Shen KR, Allen MS, Cassivi SD, et al. Surgical management of acquired nonmalignant tracheoesophageal and bronchoesophageal fistulae. Ann Thorac Surg ,2010, 90 (3):914-919.
- 4. Chappell VL, Heck Jr HA. Repair of large, iatrogenic, tracheo-esophageal fistulae. Ann Thorac Surg ,2007, 83 (2):705-706.
- 5. Bardini R, Radicchi V, Parimbelli P, et al. Repair of a recurrent benign tracheoesophageal fistula with a Gore-Tex membrane. Ann Thorac Surg, 2003, 76 (1):304-306.
- 6. Marzelle J, Dartevelle P, Khalife J, et al. Surgical management of acquired postintubation trachea-oesophageal fistulas: 27 patients. Eur J Cardiothorac Surg, 1989,3 (6):499-503.
- 7. Cherveniakov A, Tzekov C, Grigorov GE, et al. Acquired benign esophago-airway fistulas. Eur J Cardiothorac Surg, 1996, 10 (9):713-716.
- 8. Macchiarini P, Verhoye JP, Chapelier A, et al. Evaluation and outcome of different surgical techniques for postintubation tracheoesophageal fistulas. J Thorac Cardiovasc Surg, 2000, 119 (2):268-276.
- 9. Kovesi T, Rubin S. Long-term complications of congenital esophageal atresia and/or tracheoesophageal fistula. Chest, 2004, 126 (3):915-925.
- 10. 雷杰, 張娜, 駱晴, 等. 食管癌食管支氣管瘺的外科治療. 中國(guó)胸心血管外科臨床雜志, 2012, 19 (1):36-38.
- 11. Han Y, Liu K, Li X, et al. Repair of massive stent-induced tracheoesophageal fistula. J Thorac Cardiovasc Surg, 2009, 137 (4): 813-817.
- 12. Talbot ML, Hugh TB, Spratt P. Gastric antral patch oesophagoplasty for iatrogenic tracheo-oesophageal fistula. ANZ J Surg ,2007,77 (4):295-297.
- 13. Golash V. Single-stage repair of a large acquired tracheoesophageal fistula with interposition of 2 muscle pedicle flaps and laparoscopic gastrojejunostomy. J Thorac Cardiovasc Surg, 2006, 131 (6):1413-1414.
- 14. Schembre DB. Recent advances in the use of stents for esophageal disease. Gastrointest Endosc Clin N Am, 2010,20 (1):103-121.
- 15. Rabenstein T, Boosfeld C, Henrich R, et al. First use of ventricular septal defect occlusion device for endoscopic closure of an esophagorespiratory fistula using bronchoscopy and esophagoscopy. Chest, 2006,130 (3): 906-909.
- 16. Garand SA, Kareti LR, Dumont TM, et al. Thoracoscopic repair of tracheoesophageal fistula in a septuagenarian. Ann Thorac Surg, 2006, 81 (5):1899-1901.
- 17. Altorjay Á, Mucs M, Rüll M, et al. Recurrent, nonmalignant tracheoesophageal fistulas and the need for surgical improvisation. Ann Thorac Surg, 2010, 89 (6):1789-1796.