Valenti V, Martínez-Cecilia D, Priego P, Cohen P, Martínez-Isla A
Upper Gastrointestinal Surgery, Charing Cross Hospital, London, UK.
Clin Transl Oncol. 2008 Jun;10(6):377-9. doi: 10.1007/s12094-008-0216-7.
Bronchoesophageal fistula secondary to lymphoma is a very rare condition, usually associated with chemo-radiotherapy. We report a case of a patient with a non-Hodgkin's lymphoma (NHL) who, after chemotherapy, developed an oesophago-tracheal fistula. Initially it was treated conservatively but due to the lack of response, a stent was inserted. After nearly one year without success, surgery was considered. Right thoracotomy oesophagectomy and closure of the tracheal defect with an intercostal muscle flap and pericardial patch was performed. This was followed by laparoscopic creation of a gastric tube, which was successfully anastomosed to the cervical oesophagus through a cervicotomy. Unlike oesophageal cancer, NHL can have a good prognosis, so curative treatment of the fistula can be considered. Conservative treatment must always be the first option, leaving stenting or surgery for when the problem persists.
继发于淋巴瘤的支气管食管瘘是一种非常罕见的疾病，通常与放化疗有关。我们报告一例非霍奇金淋巴瘤（NHL）患者，化疗后发生食管气管瘘。起初采用保守治疗，但由于无效，遂置入支架。经过近一年的治疗仍未成功，考虑进行手术。实施了右胸切开食管切除术，并用肋间肌瓣和心包补片封闭气管缺损。随后通过腹腔镜制作胃管，并经颈部切口成功将其与颈段食管吻合。与食管癌不同，NHL预后可能良好，因此可考虑对瘘进行根治性治疗。保守治疗必须始终作为首选，问题持续存在时再考虑支架置入或手术治疗。
