食管切除术后食管气管支气管瘘的手术治疗。

E M de Groot, B F Kingma, L Goense, N P van der Kaaij, R C A Meijer, F Z Ramjankhan, P A A Schellekens, S A Braithwaite, M Marsman, J J van der Heijden, J P Ruurda, R van Hillegersberg
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引用次数: 0

摘要

本研究的目的是评估一家三级食管外科转诊中心对食管胃导管重建术后食管气管支气管瘘(ETBF)的手术治疗。该三级转诊中心纳入了所有在食管切除术和胃导管重建术后因 ETBF 而接受手术修复的患者。主要结果是 ETBF 手术治疗后的成功康复,即手术修复瘘管后 90 天气道通畅。次要结果是瘘管修补术后的临床表现、诊断和术后疗程的详细情况。2007 年至 2022 年间,共有 14 名患者接受了 ETBF 手术修复。14 名患者中,9 人接受了食管切除术并进行了颈部吻合术,5 人接受了食管切除术并进行了胸内吻合术,术后 13 人出现了吻合口漏。手术治疗包括:11 名患者采用开胸手术,用心包补片和肋间肌瓣覆盖缺损处;1 名患者采用补片,但未插入健康组织;2 名患者通过颈部切口仅用胸肌瓣修复瘘管。手术治疗后,12 名患者痊愈(86%)。两名患者(14%)因多器官功能衰竭而死亡。这项研究评估了 14 名患者在食管切除术后进行胃导管重建手术修复 ETBF 的技术和效果。12 名患者(86%)的治疗取得了成功,一般包括开胸手术和用牛心包补片覆盖缺损,然后用肋间肌进行插补。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Surgical treatment of esophago-tracheobronchial fistulas after esophagectomy.

The aim of this study was to evaluate the surgical treatment of esophago-tracheobronchial fistulas (ETBFs) that occurred after esophagectomy with gastric conduit reconstruction in a tertiary referral center for esophageal surgery. All patients who underwent surgical repair for an ETBF after esophagectomy with gastric conduit reconstruction were included in a tertiary referral center. The primary outcome was successful recovery after surgical treatment for ETBF, defined as a patent airway at 90 days after the surgical fistula repair. Secondary outcomes were details on the clinical presentation, diagnostics, and postoperative course after fistula repair. Between 2007 and 2022, 14 patients who underwent surgical repair for an ETBF were included. Out of 14 patients, 9 had undergone esophagectomy with cervical anastomosis and 5 esophagectomy with intrathoracic anastomosis after which 13 patients had developed anastomotic leakage. Surgical treatment consisted of thoracotomy to cover the defect with a pericardial patch and intercostal flap in 11 patients, a patch without interposition of healthy tissue in 1 patient, and fistula repair via cervical incision with only a pectoral muscle flap in 2 patients. After surgical treatment, 12 patients recovered (86%). Mortality occurred in two patients (14%) due to multiple organ failure. This study evaluated the techniques and outcomes of surgical repair of ETBFs following esophagectomy with gastric conduit reconstruction in 14 patients. Treatment was successful in 12 patients (86%) and generally consisted of thoracotomy and coverage of the defect with a bovine pericardial patch followed by interposition with an intercostal muscle.

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