Weiterer S, Schmidt K, Deininger M, Ulrich A, Tochtermann U, Eberhardt R, Hofer S, Weigand M A, Brenner T
Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
Klinik für Allgemeine-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
Anaesthesist. 2016 Sep;65(9):696-702. doi: 10.1007/s00101-016-0212-1. Epub 2016 Sep 5.
Here, we present a case of a tracheal fistula due to an anastomotic insufficiency following abdominothoracic esophageal resection. Despite immediate discontinuity resection, the tracheal fistula could not be surgically closed, resulting in incomplete control of the source of infection and an alternative treatment concept in the form of interventional fistula closure using a Y-tracheal stent. However, owing to existing severe acute respiratory distress syndrome (ARDS), which is associated with a considerable risk of peri-interventional hypoxia, a temporary bridging concept using venovenous extracorporeal membrane oxygenation (ECMO) was implemented successfully.
在此,我们报告一例因胸腹段食管切除术后吻合口功能不全导致气管瘘的病例。尽管立即进行了间断切除,但气管瘘无法通过手术闭合,导致感染源控制不完全,因此采用了一种替代治疗方案,即使用Y型气管支架进行介入性瘘管闭合。然而,由于存在严重的急性呼吸窘迫综合征(ARDS),且围介入期存在相当大的缺氧风险,因此成功实施了使用静脉-静脉体外膜肺氧合(ECMO)的临时桥接方案。