[内镜经瘘管引流治疗食管癌切除术后胃食管吻合口瘘伴瘘旁脓肿]
[Endoscopic trans-fistula drainage for gastroesophageal anastomotic fistula with para-fistula abscess after esophagectomy].
作者信息
Zhu Ziyi, Li Zhijun, He Zhengfu, Wang Yunzhen
机构信息
Department of Thoracic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
出版信息
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2017 May 25;46(6):637-642. doi: 10.3785/j.issn.1008-9292.2017.12.10.
To evaluate the efficiency and safety of endoscopic trans-fistula drainage (ETFD) for gastroesophageal anastomotic fistula with para-fistula abscess after esophagectomy. Among 456 esophageal cancer patients receiving esophagectomy between February 2012 and February 2017 in Sir Run Run Shaw Hospital, 15 cases were diagnosed as gastroesophageal anastomotic fistula with para-fistula abscess after surgery. Seven cases received ETFD treatment (ETFD group), and 8 cases received conventional treatment (control group). Recovery of inflammatory markers and fistula, length of hospital stay after esophagectomy and total medical expenses were compared between ETFD group and control group. All patients recovered in ETFD group. Time of white cell count returning to normal and decline of C-reactive protein, time of fistula healing and length of hospital stay after esophagectomy in ETFD group were significantly shorter than those of control group (all <0.05). And medical expenses in ETFD group was also lower (<0.05). ETFD is effective and safe for gastroesophageal anastomotic fistula with para-fistula abscess after esophagectomy.
评估内镜下经瘘管引流术（ETFD）治疗食管癌切除术后胃食管吻合口瘘伴瘘管周围脓肿的有效性和安全性。在2012年2月至2017年2月期间于浙江大学医学院附属邵逸夫医院接受食管癌切除术的456例患者中，15例术后被诊断为胃食管吻合口瘘伴瘘管周围脓肿。7例接受ETFD治疗（ETFD组），8例接受传统治疗（对照组）。比较ETFD组和对照组之间炎症指标和瘘管的恢复情况、食管癌切除术后住院时间以及总医疗费用。ETFD组所有患者均康复。ETFD组白细胞计数恢复正常时间、C反应蛋白下降时间、瘘管愈合时间及食管癌切除术后住院时间均明显短于对照组（均P<0.05）。且ETFD组医疗费用也较低（P<0.05）。ETFD治疗食管癌切除术后胃食管吻合口瘘伴瘘管周围脓肿有效且安全。
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