Fukuda Akinari, Tsushima T, Hatanaka R, Yamada Y, Takaya S, Fukuda I
Department of First Surgery, Hirosaki University School of Medicine, Hirosaki, Japan.
Kyobu Geka. 2003 Nov;56(12):1006-9.
A case of congenital esophagobronchial fistula in a 58-year-old woman was described. The patient had presented with repeated attacks of pulmonary infection from her childhood and had a history of recurrent cough after eating or drinking. Preoperative examinations including esophagogram by barium swallow revealed existence of a fistula between the upper thoracic esophagus and the right B3 bronchus. The fistula was recognized as type I of Braimbridge classification. Thoracoscopic assisted fistulectomy and diverticulectomy for esophagobronchial fistula with esophageal diverticulum were performed. The neck of the diverticulum and the fistula were divided with endo-stapling technique. Intraoperative esophagoscopy was found to be useful for the definite localization and complete excision of the fistula and the diverticulum and the avoidance of stenosis of the esophagus. Postoperative course was uneventful. It is to be considered that the present thoracoscopic assisted procedure with intraoperative esophagoscopy can be used as a standard operative procedure for esophagobronchial fistula with esophageal diverticulum.
本文描述了一例58岁女性先天性食管支气管瘘的病例。该患者自幼反复出现肺部感染，并有进食或饮水后反复咳嗽的病史。术前检查包括钡剂吞咽食管造影，显示上胸段食管与右B3支气管之间存在瘘管。该瘘管被认定为Braimbridge分类的I型。对合并食管憩室的食管支气管瘘实施了胸腔镜辅助瘘管切除术和憩室切除术。采用内镜吻合器技术分离憩室颈部和瘘管。术中食管镜检查被发现有助于明确瘘管和憩室的定位并完整切除，同时避免食管狭窄。术后病程平稳。可以认为，目前这种术中使用食管镜的胸腔镜辅助手术可作为合并食管憩室的食管支气管瘘的标准手术方法。
