Chen Ming, Ling Yi, Yang Beibei
Department of Otolaryngology, 2nd Affiliated Hospital of Medical School, Zhejiang University, PRC.
Ulus Travma Acil Cerrahi Derg. 2010 Nov;16(6):511-5.
We aimed to identify different methods of treating late perforation of the cervical esophagus.
Ten late cervical esophageal perforations were caused by foreign bodies. The subjects were divided into three groups according to their diagnosis and treatment as follows: Group I: Cases with cervical abscess were drained by lateral cervical incision and primarily repaired, Group II: Cases with cervical abscess were drained by lateral cervical incision, and any foreign body granulomas found were removed, and Group III: Foreign bodies were removed. All cases were given broad-spectrum antibiotics and were prohibited from any oral food, except Case 5.
All patients recovered without mortality and retained normal swallow function. The time for treatment in each group was different.
The conservative management of removal of foreign body, prohibition of oral food and administration of broad-spectrum antibiotics is supported. Perforations with the presence of abscess can be surgically treated by debridement closure combined with strip muscle flap repair and irrigation drainage. Granuloma can be removed by lateral cervical incision and vacuum sealing drainage.
我们旨在确定治疗颈段食管晚期穿孔的不同方法。
10例颈段食管晚期穿孔由异物所致。根据诊断和治疗方法将研究对象分为三组，具体如下：第一组：颈段脓肿病例经颈部外侧切口引流并一期修复；第二组：颈段脓肿病例经颈部外侧切口引流，切除发现的任何异物肉芽肿；第三组：取出异物。所有病例均给予广谱抗生素，除病例5外，均禁止经口进食。
所有患者均康复，无死亡病例，吞咽功能保持正常。每组的治疗时间有所不同。
支持采取取出异物、禁止经口进食及给予广谱抗生素的保守治疗方法。存在脓肿的穿孔可通过清创缝合联合带蒂肌瓣修复及冲洗引流进行手术治疗。肉芽肿可通过颈部外侧切口及负压封闭引流予以清除。
