Reichelt S, Eising E G, Pelster F W
Institut für Klinische Radiologie, Wesfälische Wilhelms-Universität Münster.
Rofo. 1991 Apr;154(4):388-92. doi: 10.1055/s-2008-1033155.
Fistulae after abdomino-thoracic operations are usually treated conservatively because of the high complication rate of repeated surgery. If the anastomoses function adequately, healing usually occurs spontaneously after four to six weeks. Amongst 271 patients with intrathoracic oesophago-gastric or oesophago-jejunal anastomoses, entero-cutaneous fistulae occurred 29 times. Extension of the fistula into the pleura or peritoneum was first excluded by using an absorbable contrast medium and then a barium contrast examination was carried out. Thoracic fistulae closed, on average, after 21.8 days and fistulae in the upper abdomen after 20.3 days. Barium sulphate stimulates granulation tissue in the fistula and therefore leads to more rapid obliteration. This improves the quality of the patient's life and reduced the time the patient has to spend in hospital. There were no local or systematic complications.
由于再次手术的并发症发生率较高,胸腹联合手术后的瘘管通常采用保守治疗。如果吻合口功能良好,通常在四到六周后自愈。在271例胸段食管胃或食管空肠吻合术患者中,发生肠皮肤瘘29例。首先使用可吸收造影剂排除瘘管向胸膜或腹膜的延伸,然后进行钡剂造影检查。胸段瘘管平均在21.8天后闭合,上腹部瘘管在20.3天后闭合。硫酸钡刺激瘘管中的肉芽组织,因此导致瘘管更快闭塞。这改善了患者的生活质量,减少了患者住院时间。没有局部或全身并发症。