Yang Guang, Li Wei-Miao, Zhao Jin-Bo, Wang Jian, Ni Yun-Feng, Zhou Yong-An, Han Yong, Li Xiao-Fei, Yan Xiao-Long
Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China.
J Thorac Dis. 2016 Nov;8(11):3225-3231. doi: 10.21037/jtd.2016.11.80.
To manage the acquired benign complicated tracheoesophageal fistula (TEF) and bronchial-gastric stump fistula (BGSF) are clinical technical challenge. The purpose of this study is to retrospectively review a surgical "double patch" technique in treating nonmalignant complicated TEF and BGSF, and then clarify the long-term curative effect of the technique.
Clinical records of 30 patients with non-malignant complicated TEF and BGSF treated by "double patch" technique in Tangdu Hospital between August 2004 and August 2014, were analyzed and summarized retrospectively.
Thirty patients (19 males and 11 females) underwent "double patch" surgical repair of acquired benign complicated TEF and BGSF. The median age of the patients was 40.2±21.1 years. The most common causes were the following: TEF [22], BGSF [8]. Post-intubation injury [6], trauma [5], foreign body and stents [10], complications from prior esophageal surgery [8], and caustic ingestion [1]. The follow-up was completed for 24 months in all the patients (100%). The operative mortality was 0% (0/30). Twenty-six patients (86.7%) recovered uneventfully while four patients (13.3%) exhibited some major complications in the perioperative and postoperative periods. One patient (3.3%) developed recurrence of tracheal fistula , two patients (6.7%) showed pneumonia, and one patient (3.3%) developed fistula esophageal anastomosis. All the 30 patients resumed oral intake finally.
The double patch technique is an effective and safe method to repair the acquired non-malignant complicated TEF and BGSF.
处理后天性良性复杂性气管食管瘘（TEF）和支气管-胃残端瘘（BGSF）是一项临床技术挑战。本研究的目的是回顾性分析一种手术“双补片”技术治疗非恶性复杂性TEF和BGSF的情况，进而阐明该技术的长期疗效。
回顾性分析2004年8月至2014年8月在唐都医院采用“双补片”技术治疗的30例非恶性复杂性TEF和BGSF患者的临床资料。
30例患者（男19例，女11例）接受了后天性良性复杂性TEF和BGSF的“双补片”手术修复。患者的中位年龄为40.2±21.1岁。最常见的病因如下：TEF[22例]，BGSF[8例]。插管后损伤[6例]，外伤[5例]，异物和支架[10例]，既往食管手术并发症[8例]，腐蚀性物质摄入[1例]。所有患者均完成了24个月的随访（100%）。手术死亡率为0%（0/30）。26例患者（86.7%）恢复顺利，4例患者（13.3%）在围手术期和术后出现一些主要并发症。1例患者（3.3%）发生气管瘘复发，2例患者（6.7%）出现肺炎，1例患者（3.3%）发生食管吻合口瘘。30例患者最终均恢复经口进食。
双补片技术是修复后天性非恶性复杂性TEF和BGSF的一种有效且安全的方法。
