Department of Surgery, University of Alberta, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Ann Thorac Surg. 2012 Jun;93(6):2076-7. doi: 10.1016/j.athoracsur.2012.01.082.
Esophagectomy is a commonly performed procedure that has a high morbidity rate. Postesophagectomy anastomotic leaks are not uncommon; however fistulas to the airways remain a rare and often catastrophic complication. Although most fistulas occur from a direct communication between a failed anastomosis and an adjacent airway, other risk factors have been identified, such as tracheal ischemia from extensive mediastinal dissection, intraoperative tracheal injuries, and cuff necrosis from prolonged intubation. Despite advancements in the management of sepsis, leaks and fistulas are still associated with a high mortality rate and continue to challenge esophageal surgeons.
食管切除术是一种常见的手术，其发病率很高。食管切除术后吻合口瘘并不少见;然而，瘘管通向气道仍然是一种罕见且通常是灾难性的并发症。虽然大多数瘘管是由于失败的吻合口与相邻气道之间的直接沟通引起的，但已经确定了其他危险因素，如广泛纵隔切开术引起的气管缺血、术中气管损伤以及长时间插管引起的套囊坏死。尽管在脓毒症的治疗方面取得了进展，但漏和瘘仍然与高死亡率相关，并继续对食管外科医生构成挑战。
