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食管旁路手术成功治疗伴有气管支气管瘘的晚期食管癌。

Advanced esophageal cancer with tracheobronchial fistula successfully treated by　esophageal bypass surgery.

作者信息

Kimura Masahiro, Ishiguro Hideyuki, Tanaka Tatsuya, Takeyama Hiromitsu

机构信息

Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.

Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.

出版信息

Int J Surg Case Rep. 2015;9:115-8. doi: 10.1016/j.ijscr.2015.02.053. Epub 2015 Mar 4.

DOI:10.1016/j.ijscr.2015.02.053
PMID:25765740
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4392374/
Abstract

INTRODUCTION

When esophageal cancer infiltrates the respiratory tract and forms a fistula, a patient's quality of life falls remarkably. Abstinence from oral feeding is necessary to prevent respiratory complications including pneumonia. Surgery is sometimes necessary to maintain quality of life. The aim of this study was to examine clinical outcomes of esophageal cancer complicated by tracheobronchial fistula.

PRESENTATION OF CASE

Twelve patients who underwent esophageal bypass between 2006 and 2011 in our hospital were studied. Patient characteristics, therapeutic course, outcome, and operation type were compared. Six patients among 8 who could not tolerate oral feeding could do so after bypass surgery. Ten patients were able to enjoy oral intake up until the last few days of life. Three patients survived for more than 10 months. In spite of undergoing an operation, 1 patient survived for only 2 months and another for 4 months. The only complication was postoperative delirium in 1 patient.

DISCUSSION

While surgical bypass is more invasive than procedures such as endoscopic stenting, we had few complications after operative intervention and were able to maintain quality of life in our patients.

CONCLUSION

This bypass procedure is a treatment option for patients with tracheobronchial fistula from advanced esophageal cancer.

摘要

引言

当食管癌侵犯呼吸道并形成瘘管时，患者的生活质量会显著下降。为预防包括肺炎在内的呼吸道并发症，必须停止经口进食。有时需要进行手术以维持生活质量。本研究的目的是探讨合并气管支气管瘘的食管癌的临床结局。

病例介绍

对2006年至2011年在我院接受食管旁路手术的12例患者进行了研究。比较了患者的特征、治疗过程、结局和手术类型。8例不能耐受经口进食的患者中，有6例在旁路手术后能够经口进食。10例患者直到生命的最后几天都能享受经口摄入。3例患者存活超过10个月。尽管接受了手术，1例患者仅存活2个月，另1例存活4个月。唯一的并发症是1例患者术后出现谵妄。

讨论

虽然手术旁路比内镜支架置入等操作更具侵入性，但我们在手术干预后并发症较少，并且能够维持患者的生活质量。

结论

这种旁路手术是晚期食管癌合并气管支气管瘘患者的一种治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3148/4392374/3da56b23a93a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3148/4392374/3da56b23a93a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3148/4392374/3da56b23a93a/gr1.jpg

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