The clinic experience and literature review with 1case of chronic tracheoesophageal fistula
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摘要: 目的:探讨慢性气管食管瘘的临床特征,为临床医生提供该病的相关治疗经验和教训。方法:通过手术成功修补1例慢性气管食管瘘患者,并分析其临床诊疗过程,结合相关文献资料,报道笔者对该病的诊疗体会。结果:患者在经胃肠造瘘、介入科植入食管支架等相关综合治疗无效后,于发病9个月后入住我科,在全身麻醉下行气管食管瘘修补术,术后10 d复查食管碘水未提示明显异常,术后12 d出院,进食无呛咳,瘘口愈合,未见术后并发症发生。结论:气管食管瘘经保守治疗后无效者,应及时行外科手术修补,术中双层缝合瘘口,并借助临近肌肉等组织加固,可达到良好效果,对该病的诊疗特征应引起耳鼻喉医生高度重视。Abstract: Objective:To investigate the clinical features of chronic tracheoesophageal fistula (TEF), provided disease-related treatment experience and lessons for clinicians.Method:To successfully repair one case of chronic tracheoesophageal fistula with surgery, and to analyze the clinical treatment process, combined with relevant literature, the author reported the experiene of diagnosis and treatment in TEF. Result:After the gastrointestinal ostomy and Stent implantation, the fistula persisted, nine months later,we took the surgery to repair the fistule, ten days postoperation, the fistule healed and esophageal iodine water examination didn't prompt obvious abnormalities, the patient was discharged without any postoperative complications 12 days postoperation. Conclusion:If conservative treatment failed with TEF, the surgical repair should be carried timely, By double sutured with fistula in surgery, and reinforced with the approaching muscle tissue, It can achieve good results.
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[1] REEDM F, MATHISEN D J.Tracheoesophageal fistula[J].Chest Surg Clin N Am, 2003, 13:271-289.
[2] MATHISEN D J, GRILLO H C, WAIN J C, et al.Management of acquired nonmalignant tracheoesophageal fi stula[J].Ann Thorac Surg, 1991, 52:759-765.
[3] SPALDING A R, BURNEY D P, RICHIE R E.Acquired benign bronchoesophageal fistulas in the adult[J].Ann Thorac Surg, 1979, 28:378-383.
[4] 翟光地, 吴奇勇, 张科, 等.外伤性食管气管瘘1例报道及文献复习[J].南京医科大学学报 (自然科学版), 2011, 31 (10):1541-1542.
[5] JONES C, LAURENCE B H, FAULKNER K W, et al.Closure of a benign broncho-oesophageal fistula by endoscopic injection of bovine collagen, cyanoacrylate glue and gelfoam[J].Aust N Z J Surg, 1996, 66:53-55.
[6] CLEMSON L A, WALSER E, GILL A, et al.Transthoracic closure of a postpneumonectomy bronchopleural fistula with coils and cyanoacrylate[J].Ann Thorac Surg, 2006, 82:1924-1926.
[7] DE LUCA G, GRIFFO S, MONACO M, et al.Combined endoscopic approach in the treatment of benign broncho-oesophageal fistula[J].Thorax, 2008, 63:1024-1025.
[8] ROKADE A V, MATHEWS J, REDDY K T.Tissue augmentation using Bioplastique as a treatment of leakage around a Provox 2voice prosthesis[J].J Laryngol Otol, 2003, 117:80-82.
[9] HILGERS F J, SOOLSMA J, ACHERSTAFF A H, et al.A thin tracheal silicone washer to solve periprosthetic leakage in laryngectomies:direct results and long-term clinical effects[J].Laryngoscope, 2008, 118:640-645.
[10] YATA S, KAMINOU T, HASHIMOTO M, Successful closure of intractable tracheoesophageal fistula using a combination of a modified silicon stent and metallic stents[J].Acta Radiol Short Rep, 2012, 1:1-3.
[11] SCHMITZ S, VAN DAMME J P, HAMOIR M.A simple technique for closure of persistent tracheoesophageal fistula after total laryngectomy[J].Otolaryngol Head Neck Surg, 2009, 140:601-603.
[12] GEHRKING E, RAAP M, SOMMER K D.Classification and management of tracheoesophageal and tracheopharyngeal fistulas after laryngectomy[J].Laryngoscope, 2007, 117:1943-1951.
[13] JACOBS K, DELAERE P R, VANDER POORTEN V L.Submucosal purse-string suture as a treatment of leakage around the indwelling voice prosthesis[J].Head Neck, 2008, 30:485-491.
[14] BESSEDE J P, BORIES F, ENAUX M, et al.Closure of esotracheal fistula after phonation implants.Technique and results of tracheal ascension[J].Ann Otolaryngol Chir Cervicofac, 1995, 112:353-355.
[15] DELAERE P R, DELSUPEHE K G.Closure of persistent tracheoesophageal fistulas after removal of the voice prosthesis[J].Laryngoscope, 1994, 104:494-496.
[16] LIU Y H, KO P J, WU Y C, et al.Silicone airway stent for treating benign tracheoesophageal fistula[J].Asian Cardiovasc Thorac Ann, 2005, 13:178-180.
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