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喉癌全喉切除术后应用可摘式咽底支架封闭咽皮瘘和咽气管瘘

Successful closure of pharyngo-cutaneous and phayryngo-tracheal fistulas using removable hypopharyngeal stent after laryngectomy for laryngeal carcinoma.

机构信息

Department of Gastroenterology and Hepatology, Head and Neck Surgery, the University of Alabama in Birmingham, AL, USA.

出版信息

Saudi J Gastroenterol. 2012 Jan-Feb;18(1):62-7. doi: 10.4103/1319-3767.91730.

Abstract

Placement of removable stents to close pharyngo-cutaneous and tracheo-pharyngeal fistulas after laryngectomy has not been reported before. This case presents the feasibility of removable esophageal stent in closing pharyngo-cutaneous and tracheo-pharyngeal fistulas after laryngectomy for laryngeal cancer. Consecutive patients who underwent placement of removable esophageal stent for closing pharyngo-cutaneous and tracheo-pharyngeal fistulas after laryngectomy for laryngeal cancer. Three patients underwent successful stent placement in the hypopharynx. The stents were well tolerated. Patient one had the stent for 14 months, leading to complete healing of the fistula. Removal was successful. The second patient was palliated but died 8 weeks after stent placement. The third patient has successful palliation of his tracheo-esophageal fistula and the stent is being exchanged every 3-4 months to palliate his fistula. Closure of pharyngo-cutaneous and tracheo-esophageal fistulas is feasible with esophageal removable stents. These stents provide alternative options when dealing with these challenging problems.

摘要

经全喉切除术后发生咽皮瘘和气管食管瘘的患者以往从未报道过可采用可移除支架进行治疗。本案例介绍了经全喉切除术后发生咽皮瘘和气管食管瘘的患者采用可移除食管支架进行治疗的可行性。

连续 3 例经全喉切除术后发生咽皮瘘和气管食管瘘的喉癌患者采用可移除食管支架进行治疗。3 例患者在咽下部成功放置了支架。患者对支架的耐受性良好。患者 1 的支架留置时间为 14 个月,瘘口完全愈合,成功取出。患者 2 进行姑息治疗,但在支架放置 8 周后死亡。患者 3 的气管食管瘘得到成功姑息治疗,每隔 3-4 个月更换一次支架以姑息治疗瘘口。食管可移除支架可用于闭合咽皮瘘和气管食管瘘。在处理这些具有挑战性的问题时,这些支架提供了替代选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/839f/3271698/215f2bdd4e1e/SJG-18-62-g001.jpg

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