First Department of Surgery, Upper Gastrointestinal and General Surgery Unit, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
First Department of Surgery, Upper Gastrointestinal and General Surgery Unit, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
In Vivo. 2020 Jul-Aug;34(4):2163-2168. doi: 10.21873/invivo.12024.
BACKGROUND/AIM: Esophagobronchial fistula is a common complication of advanced esophageal cancer, related to respiratory distress and mortality. Esophageal bypass has been successfully utilized for palliation, as bridging to definitive chemoradiotherapy. The aim of this study is to present an extremely difficult case of a mid-esophageal squamous cell carcinoma complicated with aerodigestive fistula that was treated using 3D laparoscopic-assisted esophageal bypass with curative intent.
A 49-year-old female patient presented with T4b esophageal-squamous cell carcinoma and esophagobronchial fistula. Laparoscopic-assisted V-shaped retrosternal esophageal bypass using a gastric conduit was started, which was converted to open surgery due to respiratory distress. The patient was able to undergo chemoradiotherapy treatment.
3D laparoscopic-assisted esophageal bypass can be a safe and feasible approach in patients with advanced mid-esophageal squamous cell carcinoma and esophagobroncial fistula. Additionally to the advantages of laparoscopic surgery, this operation permits oral feeding, and can be used with possible curative intent in patients with adequate response to chemoradiotherapy.
背景/目的：食管支气管瘘是晚期食管癌的常见并发症，与呼吸窘迫和死亡率有关。食管旁路术已成功用于缓解症状，作为对确定性放化疗的桥接。本研究旨在介绍一例非常困难的中食管鳞癌并发气道瘘的病例，该病例采用 3D 腹腔镜辅助有治愈意图的食管旁路术进行治疗。
一名 49 岁女性患者因 T4b 食管鳞癌和食管支气管瘘就诊。开始进行腹腔镜辅助 V 形胸骨后食管旁路术，使用胃管，但由于呼吸窘迫，该手术转为开放性手术。患者能够接受放化疗治疗。
3D 腹腔镜辅助食管旁路术可安全有效地治疗晚期中食管鳞癌和食管支气管瘘患者。除了腹腔镜手术的优势外，该手术还允许口服喂养，并可在对放化疗有充分反应的患者中，具有可能的治愈意图。
