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胸腔镜治疗支气管食管瘘:一例报告。

Thoracoscopic treatment of a broncho-esophageal fistula: A case report.

作者信息

Ginesu Giorgio C, Feo Claudio F, Cossu Maria L, Ruiu Francesca, Addis Francesca, Fancellu Alessandro, Fois Alessandro G, Paliogiannis Panagiotis, Porcu Alberto

机构信息

Unit of General Surgery, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy.

Respiratory Disease Institute, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy.

出版信息

Int J Surg Case Rep. 2016;28:74-77. doi: 10.1016/j.ijscr.2016.09.013. Epub 2016 Sep 21.

Abstract

INTRODUCTION

Broncho-esophageal fistula is a rare clinical condition which can be manifested with non-specific signs and symptoms.

PRESENTATION OF A CASE

Here, we report an adult case of a broncho-esophageal fistula in a 43-year-old man referred for chronic cough after fluid food intake and weight loss. Barium swallow, esophagogastroduodenoscopy, bronchoscopy and Computed Tomography of the chest demonstrated a broncho-esophageal fistula between the apical segmental bronchus of the lower right lobe and the middle section of the esophagus. The patient underwent video-assisted thoracoscopic surgery for resection of the fistula. No post-operative complications occurred.

DISCUSSION

Broncho-esophageal fistula in adults is rare and its diagnosis is often delayed due to the frequent lack of specific symptoms. Although there is no standard protocol, the most widely used treatment is thoracotomy with identification and dissection of the fistula tract followed by repair of bronchial and esophageal defects.

CONCLUSIONS

Video-assisted thoracoscopic surgery appears to be an effective and minimally invasive approach for the treatment of broncho-esophageal fistulas, especially in young, healthy subjects.

摘要

引言

支气管食管瘘是一种罕见的临床病症,可表现为非特异性体征和症状。

病例介绍

在此,我们报告一例43岁男性成人支气管食管瘘病例,该患者因进食流质食物后慢性咳嗽和体重减轻前来就诊。钡餐造影、食管胃十二指肠镜检查、支气管镜检查和胸部计算机断层扫描显示右下叶尖段支气管与食管中段之间存在支气管食管瘘。患者接受了电视辅助胸腔镜手术以切除瘘管。术后未发生并发症。

讨论

成人支气管食管瘘较为罕见,由于常常缺乏特异性症状,其诊断往往会延迟。尽管没有标准方案,但最广泛使用的治疗方法是开胸手术,识别并分离瘘管,随后修复支气管和食管缺损。

结论

电视辅助胸腔镜手术似乎是治疗支气管食管瘘的一种有效且微创的方法,尤其适用于年轻、健康的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c69/5043393/20ae83461a3b/gr1.jpg

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