Koga M, Akiyama K, Inoue T, Hasegawa M, Funahashi M, Ohmori K, Negishi N, Sezai Y
Second Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
Kyobu Geka. 2000 Aug;53(9):787-90.
We report our experience of the treatment of a 60-year-old man with upper tracheal fistula which developed on the 11th day after radical surgery for esophageal cancer. Primary treatment to close the fistula was unsuccessful, resulting in the involvement of empyema due to infection. Controlled ventilation with T-tube and drainage through a chest tube for 2 months lead to depuration of the thoracic cavity. As a strategy for secondary closure of the fistula, fenestration was performed on the 87th day postoperatively. The patient's overall condition improved thereafter and closure was being considered. However, the patient died on the 116th day postoperatively due to supervenient aspiration pneumonia. Thus, long-term controlled ventilation with a T-tube was beneficial for the treatment of central airway injury.
我们报告了对一名60岁男性食管癌根治术后第11天出现气管上段瘘的治疗经验。闭合瘘口的初次治疗未成功，导致感染并发脓胸。采用T形管控制通气并通过胸腔闭式引流2个月，使胸腔得以净化。作为瘘口二期闭合的策略，在术后第87天行开窗术。此后患者整体状况改善，考虑进行闭合手术。然而，患者在术后第116天因并发吸入性肺炎死亡。因此，长期使用T形管控制通气对治疗中央气道损伤有益。
