Gurram Ram Prakash, Gnanasekaran Senthil, Kalayarasan Raja, Biju Pottakkat, Sandip Chandrasekar
Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.
Cureus. 2020 Aug 18;12(8):e9854. doi: 10.7759/cureus.9854.
Compared to less invasive measures, surgical repair is the most effective modality for managing benign acquired tracheoesophageal fistula (TEF). Traditionally, this involves dismantling of the fistula and suture repair of tracheal and esophageal defects using a lateral or direct approach. However, the best approach remains a subject of debate. We describe a novel and simple technique for dismantling a benign acquired TEF with the use of an endo-stapler and interposition with sternocleidomastoid (SCM) muscle flap. Eleven TEF patients underwent repair using this stapled repair technique. Retrospectively, the perioperative and long-term outcomes were assessed in these patients. There were no cases of procedure-related mortality or airway-related complications. Two patients developed transient vocal cord palsy and one developed esophageal leak. At a mean follow-up of 21.4 months, no fistula recurrence, dysphagia, or tracheal stenosis was observed. Hence stapled dismantling and SCM muscle interposition is a simple and safe technique for repair of benign acquired TEF.
与侵入性较小的措施相比,手术修复是治疗良性后天性气管食管瘘(TEF)最有效的方式。传统上,这需要拆除瘘管,并采用外侧或直接入路对气管和食管缺损进行缝合修复。然而,最佳方法仍是一个有争议的问题。我们描述了一种新颖且简单的技术,使用内镜吻合器拆除良性后天性TEF,并置入胸锁乳突肌(SCM)肌瓣。11例TEF患者采用这种吻合器修复技术进行了修复。回顾性地评估了这些患者的围手术期和长期结果。没有与手术相关的死亡病例或与气道相关的并发症。2例患者出现短暂性声带麻痹,1例出现食管漏。平均随访21.4个月时,未观察到瘘管复发、吞咽困难或气管狭窄。因此,吻合器拆除和SCM肌瓣置入是修复良性后天性TEF的一种简单且安全的技术。