Grebenik C R
Department of Anaesthesia and Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia.
Br J Anaesth. 1989 Oct;63(4):492-6. doi: 10.1093/bja/63.4.492.
The anaesthetic management is described, of a patient with malignant tracheo-oesophageal fistula undergoing palliative oesophageal bypass. The oesophagus was divided and closed at its upper end and replaced with a segment of colon. The fistula remained in situ and fundoplication was performed to allow drainage of the oesophageal remnant but prevent reflux of gastric contents. During a subsequent anaesthetic, gross intestinal distension occurred when gas that had passed through the fistula was unable to vent. The problems of dealing with patients with malignant tracheo-oesophageal fistula are discussed.
本文描述了一名患有恶性气管食管瘘的患者在接受姑息性食管旁路手术时的麻醉管理情况。将食管在其上端切断并封闭，然后用一段结肠进行替代。瘘管保留原位，并进行了胃底折叠术，以引流食管残余部分，但防止胃内容物反流。在随后的一次麻醉过程中，当通过瘘管的气体无法排出时，出现了严重的肠道扩张。文中还讨论了处理恶性气管食管瘘患者的相关问题。
