外科重建治疗获得性食管气管-支气管瘘(附8例报告)  

Surgical reconstruction for the treatment of the acqired esophagotracheo-bronchial fistulas(A report of 8 cases)

作　　者：傅鉴[1] 林宇[1] 钟小生[1] 刘石勇[1] 陈钢[2] 

机构地区：[1]广州中医药大学附属省中医院心胸外科,510120 [2]南方医科大学南方医院心胸外科,510515

出　　处：《岭南现代临床外科》2006年第1期58-60,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨获得性食管气管-支气管瘘的病因、诊断及外科处理原则。方法对我科及南方医院胸外科自1997.8-2005.7共收治8例食管呼吸道瘘的病例进行回顾性分析。术前诊断主要靠食管钡餐;位置和大小主要靠气管镜和食管镜。薄层CT扫描也具有较好诊断价值。全组采用的手术方法有三种:1.食管、气管分别修补术;2.胸膜或带蒂肌瓣封闭瘘口术,胸骨后结肠或胃代食管;3.食管支气管瘘加下肺叶切除、食管重建术。结果全组接受手术治疗者7例全部治愈出院;颈部食管结肠吻合口瘘出现1例,全部病例均随访。4例良性病变所致瘘病人均存活。恶性病变所致3例均于术后3-6月死亡,主要死因是肿瘤扩散致多器官衰竭。未接受手术治疗者1例死亡。结论外科干预是获得性食管气管-支气管瘘的首选治疗。根据不同的病人选择不同的术式去重建食管和气管的连续性,才可取得良好的效果。Objective To investigate the cause,diaguosis and principle of surgical treatment for the acquired esophagotracheo-bronchial fistulas. Methods From August 1997 to July 2005,8 cases with esophagotracheo-bronchial fistulas were analyzed retrospectively. Results Postoperative complications： esophago-colonic anastomotic fistula of neck was found in one case. Among them, 7 cases received operation were cured to discharge from hospital and 1 case died from given up treatment. Follow-up was gotten in all cases. 4 cases with benign lesion resulting in fitula were survival. 3 cases with malignant lesion resulting in fistula were death 3 to 6 months after operation and the main cause of death was multiple organ failure resulting from tumor disffusion. Conclusion Surgical intervention is first choice for the treatment of acquired esophagotracheo-bronchial fistulas. According to the patient＇s different condition, the different procedures should be selected to reconstruct the continuity between esophagus and trachea or bronchus.

关 键 词：外科重建 获得的 食管气管-支气管瘘 

分 类 号：R655.4[医药卫生—外科学]