Chen Tzu-Chun, Huang Pei-Ming, I-Rue Lai
1 Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
2 Department of Anatomy and Cell Biology, Medical College, National Taiwan University, Taipei, Taiwan.
Int Surg. 2015 Jul;100(7-8):1225-8. doi: 10.9738/INTSURG-D-14-00191.1.
This paper is designed to report the endoscopic treatment for a rare esophagopleural fistula after total gastrectomy. Esophagopleural fistula is a rare complication following total gastrectomy. Nonoperative treatment using endoscopic injection of tissue glue is a less invasive and effective option. The history, treatment, and options for managing an esophagopleural fistula following gastrectomy are discussed. A 53-year-old female patient underwent total gastrectomy for advanced gastric cancer. An anastomotic leak with esophagopleural fistula formation developed at the esophagojejunostomy site. The fistula was successfully managed by endoscopic injection with n-butyl-2-cyanoacrylate into the fistula, chest tube drainage, systemic antibiotics, and total parenteral nutrition. This case report suggests that combing effective drainage and the use of n-butyl-2-cyanoacrylate of nonoperative treatment options for esophagopleural fistula.
本文旨在报道全胃切除术后罕见食管胸膜瘘的内镜治疗。食管胸膜瘘是全胃切除术后罕见的并发症。采用内镜注射组织胶的非手术治疗是一种侵入性较小且有效的选择。本文讨论了胃切除术后食管胸膜瘘的病史、治疗及处理方法。一名53岁女性患者因进展期胃癌接受了全胃切除术。在食管空肠吻合口处发生吻合口漏并形成食管胸膜瘘。通过内镜向瘘口注射正丁基-2-氰基丙烯酸酯、胸腔闭式引流、全身使用抗生素及全胃肠外营养,成功处理了该瘘。本病例报告提示,联合有效的引流及使用正丁基-2-氰基丙烯酸酯是食管胸膜瘘非手术治疗的有效选择。