Lee So Young, Kim Kun Woo, Lee Jae-Ik, Park Dong-Kyun, Park Kook-Yang, Park Chul-Hyun, Son Kuk-Hui
Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center.
Department of Gastroenterology, Gachon University Gil Medical Center.
Korean J Thorac Cardiovasc Surg. 2018 Feb;51(1):76-80. doi: 10.5090/kjtcs.2018.51.1.76. Epub 2018 Feb 5.
Early diagnosis followed by primary repair is the best treatment for spontaneous esophageal perforation. However, the appropriate management of esophageal leakage after surgical repair is still controversial. Recently, the successful adaptation of vacuum-assisted closure therapy, which is well established for the treatment of chronic surface wounds, has been demonstrated for esophageal perforation or leakage. Conservative treatment methods require long-term fasting with total parenteral nutrition or enteral feeding through invasive procedures, such as percutaneous endoscopic gastrostomy or a feeding jejunostomy. We report 2 cases of esophageal leakage after primary repair treated by endoscopic vacuum therapy with continuous enteral feeding using a Sengstaken-Blakemore tube.
早期诊断并进行一期修复是自发性食管穿孔的最佳治疗方法。然而,手术修复后食管漏的恰当处理仍存在争议。最近,已证实对于食管穿孔或漏,成功应用了在慢性体表伤口治疗中已成熟的负压封闭引流疗法。保守治疗方法需要长期禁食并通过全胃肠外营养或经皮内镜下胃造口术或空肠造口术等侵入性操作进行肠内喂养。我们报告2例一期修复后食管漏的病例,采用经鼻胃管持续肠内喂养的内镜下负压治疗。