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用于异物取出的颈部食管切开术——病例报告及文献综述

Cervical esophagotomy for foreign body extraction - Case report and comprehensive review of the literature.

作者信息

Heger Patrick, Weber Tim F, Rehm Johannes, Pathil Anita, Decker Frank, Schemmer Peter

机构信息

Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, 69120, Germany.

Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, 69120, Germany.

出版信息

Ann Med Surg (Lond). 2016 Apr 7;7:87-91. doi: 10.1016/j.amsu.2016.04.001. eCollection 2016 May.

Abstract

INTRODUCTION

Esophageal foreign bodies are an important and serious cause of morbidity and mortality in both children and adults. Due to the possibility of serious complications, i.e. perforation, necrosis, mediastinitis, and fistulation, rapid and accurate diagnostic measures with subsequent therapy are necessary.

CASE REPORT

We are reporting a case of a 55-year-old, mentally impaired patient that has swallowed a foreign body, which subsequently became lodged in his esophagus. Due to the fact that endoscopic removal was not possible and there was a high risk of complications such as esophageal perforation or mediastinitis in this case, we performed cervical esophagotomy and successfully extracted the foreign body. The patient showed an uneventful postoperative process and could be discharged on Day 11 after the operation.

COMPREHENSIVE REVIEW

Furthermore, we performed a systematic review of the literature to identify all studies that described a surgical approach through esophagotomy in cases of foreign body ingestion and found 11 publications describing the cases of 29 patients. These studies reported an overall complication rate of 17.2% and a mortality rate of 0%.

CONCLUSION

Our findings suggest that esophagotomy could be a viable approach for the extraction of foreign bodies especially in some cases when endoscopic removal was not successful and the risk of esophageal perforation is high.

摘要

引言

食管异物是儿童和成人发病及死亡的重要且严重原因。由于可能出现严重并发症,如穿孔、坏死、纵隔炎和瘘管形成,因此需要迅速且准确的诊断措施及后续治疗。

病例报告

我们报告一例55岁智力障碍患者,其吞食异物后异物嵌顿于食管。鉴于该病例无法进行内镜取出且存在食管穿孔或纵隔炎等并发症的高风险,我们实施了颈部食管切开术并成功取出异物。患者术后恢复顺利,术后第11天出院。

综合回顾

此外,我们对文献进行了系统回顾,以确定所有描述异物吞食病例中通过食管切开术的手术方法的研究,发现11篇文献描述了29例患者的病例。这些研究报告的总体并发症发生率为17.2%,死亡率为0%。

结论

我们的研究结果表明,食管切开术可能是取出异物的可行方法,特别是在某些内镜取出不成功且食管穿孔风险高的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df0e/4840399/53fd67a86fbb/gr1.jpg

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