Spelsberg F W, Wollenberg B, Weidenhagen R, Lang R A, Winter H, Jauch K-W, Hüttl T P
Chirurgische Klinik und Poliklinik, Campus Grosshadern, Universität München, Marchioninistrasse 15, 81377, München.
HNO. 2009 Oct;57(10):1065-9. doi: 10.1007/s00106-009-1982-4.
Postradiotherapy or malignant esophagotracheal fistulas still represent a dilemma. In the absence of surgical options attempts are made to close the fistula endoscopically by means of esophageal and/or tracheal stents. Tracheal stent placement in laryngectomy patients with terminal stomas is particularly problematic due to the risk of stent dislocation during cannula replacement
Six laryngectomy patients with high esophagotracheal fistulas were each fitted with a coated Ultraflex stent (Boston Scientific, Watertown/MA, US). Following skin undermining, the stents were fixed to the tracheostoma with interrupted sutures and the skin flaps attached to the stent with a second row of sutures.
Fistulas could be completely closed in all patients and there were no cases of stent dislocation. Cannula replacement was unproblematic.
Suture fixation of tracheal stents is a viable procedure even for patients with esophagotracheal fistulas and terminal tracheostomy following laryngectomy.
放疗后或恶性食管气管瘘仍然是一个难题。在没有手术选择的情况下，人们尝试通过食管和/或气管支架在内镜下封闭瘘口。对于有终末造口的喉切除患者，由于在更换套管时支架移位的风险，放置气管支架尤其成问题。
6例患有高位食管气管瘘的喉切除患者，每人都安装了一个带涂层的Ultraflex支架（美国波士顿科学公司，马萨诸塞州沃特敦）。在皮下潜行分离后，用间断缝线将支架固定于气管造口，并用第二排缝线将皮瓣附着于支架。
所有患者的瘘口均能完全闭合，且无支架移位病例。套管更换顺利。
即使对于喉切除术后患有食管气管瘘和终末气管造口的患者，气管支架的缝线固定也是一种可行的方法。
