Roche M, Gilly F, Carret J P, Guibert B, Braillon G, Dejour H
Ann Chir. 1989;43(5):343-7.
Difficult diagnostic and therapeutic problems are raised by perforations of the cervical oesophagus or hypopharynx in patients undergoing surgery to the cervical spine via an anterior approach. Based on their experience of three recent cases, the authors review the diagnostic approach, based on clinical examination and diatrizoate sodium oesophageal series, and propose conservative treatment consisting of surgical drainage with or without suture of the perforation and without removal of the osteosynthesis material, appropriate antibiotic therapy and hypercaloric enteral nutrition via nasogastric tube. The prevention of this complication is based on correct use of surgical retractors.
经前路行颈椎手术的患者发生颈段食管或下咽穿孔会引发诊断和治疗难题。基于近期三例病例的经验,作者回顾了基于临床检查和食管泛影葡胺造影的诊断方法,并提出保守治疗方案,包括有或无穿孔缝合的手术引流、不取出骨合成材料、适当的抗生素治疗以及经鼻胃管给予高热量肠内营养。预防该并发症的关键在于正确使用手术牵开器。