The Two-Tube Method for Treating Thoracogastric Airway Fistula.

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Thoracic and Cardiovascular Surgeon Pub Date : 2024-03-01 Epub Date: 2023-07-04 DOI:10.1055/a-2122-7149
Chenchen Zhang, Xiaobing Li, Zhanfeng He, Shuai Wang, Meipan Yin, Yaozhen Ma, Gang Wu
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引用次数: 0

Abstract

Background:  Thoracogastric airway fistula (TGAF) is a fatal complication after esophagectomy. Without active treatment, patients may die of intractable pneumonia, sepsis, massive hemoptysis, or respiratory failure. We determined the clinical value of the two-tube method that involves the precise interventional placement of the nasojejunal tube (NJT) and nasogastric tube (NGT) for TGAF.

Methods:  Clinical data of patients with TGAF who had undergone fluoroscopic interventional placement of NJT and NGT were analyzed retrospectively. The paired t-test was used to compare the index values before and after treatment. Statistical significance was set at p < 0.05.

Results:  In total, 212 patients (177 male and 35 female; mean age, 61.3 ± 7.9 years [47-73]) with TGAF who had undergone the two-tube method were included. Posttreatment chest spiral computed tomography and inflammatory indicators showed significantly improved pulmonary inflammation compared with that before treatment. The patients' general condition remained stable. Of 212 patients, 12 (5.7%) underwent surgical repair, 108 (50.9%) received placement of airway stents, and 92 (43.4%) cases only continued treatment with the two-tube method owing to patients' conditions. In total, 47.8% (44/92) patients died of secondary pulmonary infection, bleeding, and primary tumor progression, whereas 52.2% (48/92) patients survived with both tubes.

Conclusion:  The two-tube method, which involves the precise interventional placement of the NJT and NGT, is simple, safe, and effective for treating TGAF. This method is a bridge for successive treatments or a treatment itself for patients who are unsuitable for surgical repair or stent placement.

治疗胸胃气道瘘的双管法。
背景:胸胃气道瘘(TGAF)是食管切除术后的一种致命并发症。如果不积极治疗,患者可能死于顽固性肺炎、败血症、大咯血或呼吸衰竭。我们确定了双管法治疗 TGAF 的临床价值,该方法包括精确介入放置鼻空肠管(NJT)和鼻胃管(NGT):方法:对接受过透视介入置入鼻空肠管和鼻胃管治疗的 TGAF 患者的临床数据进行回顾性分析。采用配对 t 检验比较治疗前后的指标值。统计显著性以 p 为标准:共纳入 212 例接受双管法治疗的 TGAF 患者(男 177 例,女 35 例;平均年龄 61.3 ± 7.9 岁 [47-73])。与治疗前相比,治疗后胸部螺旋计算机断层扫描和炎症指标显示肺部炎症明显改善。患者的一般情况保持稳定。在 212 例患者中,12 例(5.7%)接受了手术修补,108 例(50.9%)接受了气道支架置入,92 例(43.4%)因病情原因仅继续采用双管法治疗。总计47.8%(44/92)的患者死于继发性肺部感染、出血和原发性肿瘤进展,而52.2%(48/92)的患者在双管治疗后存活:结论:双管法涉及 NJT 和 NGT 的精确介入置管,是治疗 TGAF 的简单、安全和有效的方法。这种方法是连续治疗的桥梁,对于不适合手术修复或支架置入的患者来说,这种方法本身就是一种治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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