{"title":"内镜下粘膜夹层修复成人获得性支气管食管瘘的麻醉处理1例。","authors":"Bin Zhu, Jiao Li, Zhigang Li, Jing Chang","doi":"10.1177/10892532251335183","DOIUrl":null,"url":null,"abstract":"<p><p><b>Purpose:</b> Acquired broncho-esophageal fistula (BEF) presents significant challenges in perioperative anesthesia management, especially when direct repair is not feasible. This case report highlights the anesthesia management strategies used during endoscopic submucosal dissection (ESD), an indirect repair method for BEF, focusing on airway preservation and minimizing intraoperative complications. <b>Result:</b> A 64-year-old male with BEF caused by small cell lung cancer underwent ESD. Anesthesia management focused on preserving spontaneous breathing and preventing air leaks through continuous endotracheal aspiration. A double-lumen tracheal tube was used to achieve selective lung ventilation, and recruitment maneuvers were performed postoperatively to improve lung function. The surgery was successfully completed without significant adverse effects, and postoperative follow-up showed improvement in the patient's condition. <b>Conclusion:</b> ESD represents a viable option for the indirect repair of BEF in patients unsuitable for direct surgical repair. Perioperative anesthetic strategies, such as spontaneous breathing preservation and continuous airway suction, may reduce complications. This case highlights the importance of a tailored, multidisciplinary approach in managing complex thoracic surgical cases.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"10892532251335183"},"PeriodicalIF":1.1000,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Anesthesia Management of Acquired Adult Broncho-Esophageal Fistula Repair Using Endoscopic Submucosal Dissection: A Case Report.\",\"authors\":\"Bin Zhu, Jiao Li, Zhigang Li, Jing Chang\",\"doi\":\"10.1177/10892532251335183\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Purpose:</b> Acquired broncho-esophageal fistula (BEF) presents significant challenges in perioperative anesthesia management, especially when direct repair is not feasible. This case report highlights the anesthesia management strategies used during endoscopic submucosal dissection (ESD), an indirect repair method for BEF, focusing on airway preservation and minimizing intraoperative complications. <b>Result:</b> A 64-year-old male with BEF caused by small cell lung cancer underwent ESD. Anesthesia management focused on preserving spontaneous breathing and preventing air leaks through continuous endotracheal aspiration. A double-lumen tracheal tube was used to achieve selective lung ventilation, and recruitment maneuvers were performed postoperatively to improve lung function. The surgery was successfully completed without significant adverse effects, and postoperative follow-up showed improvement in the patient's condition. <b>Conclusion:</b> ESD represents a viable option for the indirect repair of BEF in patients unsuitable for direct surgical repair. Perioperative anesthetic strategies, such as spontaneous breathing preservation and continuous airway suction, may reduce complications. This case highlights the importance of a tailored, multidisciplinary approach in managing complex thoracic surgical cases.</p>\",\"PeriodicalId\":46500,\"journal\":{\"name\":\"Seminars in Cardiothoracic and Vascular Anesthesia\",\"volume\":\" \",\"pages\":\"10892532251335183\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-05-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Seminars in Cardiothoracic and Vascular Anesthesia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/10892532251335183\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Cardiothoracic and Vascular Anesthesia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/10892532251335183","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Anesthesia Management of Acquired Adult Broncho-Esophageal Fistula Repair Using Endoscopic Submucosal Dissection: A Case Report.
Purpose: Acquired broncho-esophageal fistula (BEF) presents significant challenges in perioperative anesthesia management, especially when direct repair is not feasible. This case report highlights the anesthesia management strategies used during endoscopic submucosal dissection (ESD), an indirect repair method for BEF, focusing on airway preservation and minimizing intraoperative complications. Result: A 64-year-old male with BEF caused by small cell lung cancer underwent ESD. Anesthesia management focused on preserving spontaneous breathing and preventing air leaks through continuous endotracheal aspiration. A double-lumen tracheal tube was used to achieve selective lung ventilation, and recruitment maneuvers were performed postoperatively to improve lung function. The surgery was successfully completed without significant adverse effects, and postoperative follow-up showed improvement in the patient's condition. Conclusion: ESD represents a viable option for the indirect repair of BEF in patients unsuitable for direct surgical repair. Perioperative anesthetic strategies, such as spontaneous breathing preservation and continuous airway suction, may reduce complications. This case highlights the importance of a tailored, multidisciplinary approach in managing complex thoracic surgical cases.