食管鳞状细胞癌食管切除术后带蒂肌瓣填充及胸廓成形术治疗严重胸段胃皮肤瘘：1例报告
Surgical treatment of the severe thoracic gastrocutaneous fistula by pedicled muscle flap filling and thoracoplasty after oesophagectomy for oesophageal squamous cell carcinoma: A case report.
作者信息
Yu Dongmin, Zhou Zizi, Zhang Xiaoming
机构信息
Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
Department of Cardio-Thoracic Surgery, Shenzhen University General Hospital, Shenzhen, China; Department of Plastic and Reconstructive Surgery, BG Unfallklinik Ludwigshafen, University of Heidelberg, Heidelberg, Germany.
出版信息
Int J Surg Case Rep. 2019;55:76-79. doi: 10.1016/j.ijscr.2019.01.009. Epub 2019 Jan 24.
BACKGROUND
Thoracic anastomotic fistula (TAF) is a severe postoperative complication of oesophagectomy, and its occurrence coupled with a thoracic gastrocutaneous fistula (TGCF) and tracheostenosis is very unusual and may lead to a fatal consequence.
CASE PRESENTATION
We describe a case of an old female diagnosed with mid-oesophageal carcinoma, who presented with a TAF after oesophagectomy, which was healed by an effective treatment, while a severe TGCF and tracheostenosis appeared one month postoperation. The complications were detected by gastroscopy, barium oesophagogram and thoracic computed tomography (CT). Through surgical treatments, including pedicled muscle flap filling and thoracoplasty, and a correlated corrective procedure, the patient completely recovered and was discharged six months after the admission.
CONCLUSION
Treatment by pedicled muscle flap filling and thoracoplasty after oesophagectomy for oesophageal squamous cell carcinoma can be a curative alternative for the severe thoracic gastrocutaneous fistula.
背景
胸段吻合口瘘（TAF）是食管切除术后的一种严重并发症，其发生合并胸段胃皮瘘（TGCF）和气管狭窄非常罕见，可能导致致命后果。
病例报告
我们描述了一例老年女性患者，诊断为食管中段癌，食管切除术后出现TAF，经有效治疗愈合，术后1个月出现严重TGCF和气管狭窄。通过胃镜、食管钡餐造影和胸部计算机断层扫描（CT）检测到这些并发症。通过包括带蒂肌瓣填充和胸廓成形术在内的手术治疗以及相关矫正手术，患者完全康复，入院6个月后出院。
结论
食管鳞状细胞癌食管切除术后采用带蒂肌瓣填充和胸廓成形术治疗严重胸段胃皮瘘可能是一种有效的替代方法。
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