新型多模态内镜下闭合术后食管瘘
Novel multimodality endoscopic closure of postoperative esophageal fistula.
作者信息
Markar Sheraz R, Koehler Richard, Low Donald E, Ross Andrew
机构信息
Department of Thoracic Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
出版信息
Int J Surg Case Rep. 2012;3(11):577-9. doi: 10.1016/j.ijscr.2012.08.001. Epub 2012 Aug 7.
INTRODUCTION
Esophageal fistula following esophagectomy is associated with significant morbidity and mortality.
PRESENTATION OF CASE
We present the case of a 71-year-old man who underwent salvage Ivor-Lewis esophagectomy, following definitive chemoradiotherapy 1 year previously. On postoperative day 9 the patient complained of chest pain, and a CT scan demonstrated extravasation of oral contrast from the gastric conduit into the right chest. A right chest drain and fully covered esophageal stent were placed at this time. Despite these measures, after 8 weeks, the esophageal fistula persisted. Ultimately, fistula closure was achieved using an interventional radiology-guided, endoscopically placed over-the-scope clip (OTSC). The patient had no further complications and was well at 3 months follow-up.
DISCUSSION
The case reported herein describes this novel, combined-modality approach to esophageal fistula closure.
CONCLUSION
This case report demonstrates a novel, minimally invasive, multidisciplinary approach to the closure of a post-esophagectomy anastamotic leak.
引言
食管切除术后发生食管瘘与显著的发病率和死亡率相关。
病例介绍
我们报告一例71岁男性患者，该患者在1年前接受了根治性放化疗后接受了挽救性Ivor-Lewis食管切除术。术后第9天，患者主诉胸痛，CT扫描显示口服造影剂从胃管道渗入右胸。此时放置了右胸引流管和完全覆盖的食管支架。尽管采取了这些措施，但8周后食管瘘仍持续存在。最终，通过介入放射学引导、内镜下放置的全覆膜金属夹（OTSC）实现了瘘口闭合。患者无进一步并发症，随访3个月时情况良好。
讨论
本文报告的病例描述了这种用于闭合食管瘘的新型联合治疗方法。
结论
本病例报告展示了一种用于闭合食管切除术后吻合口漏的新型、微创、多学科方法。
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