Ji Hongquan, Liu Dandan, You Weitao, Zhou Fang, Liu Zhongjun
From the Orthopaedic Department, Peking University Third Hospital, Beijing, China.
Spine (Phila Pa 1976). 2015 Feb 1;40(3):E183-5. doi: 10.1097/BRS.0000000000000712.
Case report.
To share our successful experience in treating 1 case of esophageal perforation after anterior revision cervical spine surgery with open-wound management.
Early diagnosis and surgical treatment is widely adopted in the management of esophageal complications after anterior cervical spine surgery, but the management of wound after surgical repair of esophageal perforation is rarely discussed.
One patient underwent revision anterior cervical spine surgery because of displaced hardware and poor alignment of cervical spine. Esophageal perforation was incurred intraoperatively and found on the first postoperative day. Repair surgery was carried out immediately afterward. During the surgery, esophageal perforation was closed with a suture, and reinforced with a sternocleidomastoid muscle flap. The wound was loosely closed with aspirating drainage. Two days after the surgery, the patient began to show signs of recurrent esophageal leakage and severe secondary wound infection. The wound was then reopened completely before a continuous irrigation and drainage system was positioned in place.
In 12 weeks, the esophageal perforation healed without complications or loosening of instrumentation.
Open-wound management succeeded in this patient after surgical repair of esophageal perforation caused by revision anterior cervical spine surgery.
病例报告。
分享我们成功治疗1例颈椎前路翻修术后食管穿孔并采用开放伤口处理的经验。
早期诊断和手术治疗在颈椎前路手术后食管并发症的处理中被广泛采用，但食管穿孔手术修复后的伤口处理很少被讨论。
1例患者因内固定移位和颈椎排列不齐接受颈椎前路翻修手术。术中发生食管穿孔，术后第1天发现。随后立即进行修复手术。手术中，用缝线关闭食管穿孔，并用胸锁乳突肌瓣加固。伤口用吸引引流松散缝合。术后2天，患者开始出现食管再次渗漏和严重继发性伤口感染的迹象。然后完全重新打开伤口，在此之前放置一个持续冲洗引流系统。
12周后，食管穿孔愈合，无并发症或内固定松动。
颈椎前路翻修手术导致食管穿孔手术修复后，开放伤口处理在该患者中取得成功。
4级。
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