Scappaticci Ermanno, Ardissone Francesco, Baldi Sergio, Coni Francesco, Revello Flavio, Filosso Pier Luigi, Ruffini Enrico
Respiratory Diseases, Ospedale San Giovanni Battista, and University of Torino, Torino, Italy.
Ann Thorac Surg. 2004 Jan;77(1):328-9. doi: 10.1016/s0003-4975(03)01379-1.
Management of acquired nonmalignant tracheo-esophageal fistula (TEF) in mechanically ventilated patients is controversial. Surgical correction is often contraindicated because the high operative risk and spontaneous closure is unlikely due to the positive pressure ventilation. We present a case of successful closure of an iatrogenic TEF in a mechanically ventilated patient with bronchoscopic application of fibrin glue. The technique may be proposed in high-risk patients as either an alternative to surgery or as a first-line attempt before surgical correction.
机械通气患者获得性非恶性气管食管瘘(TEF)的管理存在争议。手术矫正通常是禁忌的,因为手术风险高,且由于正压通气,自发闭合的可能性不大。我们报告一例机械通气患者医源性TEF通过支气管镜应用纤维蛋白胶成功闭合的病例。该技术可作为手术替代方案或手术矫正前的一线尝试,推荐用于高危患者。