Dimofte Gabriel, Crumpei Felicia, Grigoraş Mihai, Isloi Anca, Grigoraş Ioana
1st Surgical Clinic, Gr. T. Popa University of Medicine and Pharmacy, Str. Vasile Conta no.1, 6600 Iaşi, Romania.
Rom J Gastroenterol. 2002 Jun;11(2):153-8.
Esophago-respiratory neoplastic fistulas present serious problems of management, mostly because of the severe status of the patient. The authors present the case of a 49-year-old patient with a malignant eso-tracheal fistula manifesting as mild dysphagia and dyspnoea. An endoscopic palliative treatment of the fistula was performed introducing a metallic coated stent into the esophagus. The multiple stent displacement required a definitive, very high positioning of the stent in the lower pharynx, with significant discomfort. Severe respiratory conditions regressed and the patient survived 6 months after the initial placement. The authors suggest endoscopic palliation with esophageal prosthesis as the therapeutic choice in those cases not amenable to surgery.
食管-呼吸道肿瘤性瘘管在治疗上存在严重问题,主要是因为患者的病情严重。作者介绍了一例49岁患有恶性食管-气管瘘管的患者,表现为轻度吞咽困难和呼吸困难。通过在内镜下将金属覆膜支架置入食管对瘘管进行姑息治疗。多次支架移位需要将支架最终放置在下咽的非常高的位置,患者感到明显不适。严重的呼吸状况得到缓解,患者在初次放置支架后存活了6个月。作者建议,对于那些不适合手术的病例,内镜下放置食管假体进行姑息治疗是一种治疗选择。