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食管癌合并支气管食管瘘患者行食管切除术后的隆嵴重建与双套管重建。

Carinal resection and double-barrel reconstruction following oesophagectomy for oesophageal carcinoma with broncho-oesophageal fistula.

机构信息

Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.

Department of Esophageal and Gastroenterological Surgery, Juntendo University School of Medicine, Tokyo, Japan.

出版信息

Interact Cardiovasc Thorac Surg. 2021 Apr 8;32(3):489-491. doi: 10.1093/icvts/ivaa279.

Abstract

A 54-year-old man presenting with dysphagia was diagnosed with locally advanced oesophageal carcinoma with a broncho-oesophageal fistula (c-T4bN2M0 stage IVa). Concurrent chemoradiotherapy (60 Gy) was planned; however, bleeding from the oesophageal lesions progressed during chemoradiotherapy (16 Gy). Oesophagectomy with carinal resection and double-barrelled reconstruction was performed. Despite the inevitable recurrent nerve palsy and a minor fistula at the tracheal anastomosis, he recovered with conservative treatment and was discharged 4 months after the salvage surgery. He is alive without recurrence 28 months after the surgery.

摘要

一位 54 岁男性因吞咽困难就诊,被诊断为局部晚期食管癌伴支气管食管瘘(c-T4bN2M0 Ⅳa 期)。计划进行同期放化疗(60Gy);然而,在放化疗期间(16Gy)食管病变出血进展。进行了食管切除术、隆突切除和双管重建。尽管不可避免地出现了膈神经麻痹和气管吻合口小瘘,但他通过保守治疗恢复,在挽救性手术后 4 个月出院。手术后 28 个月,他无复发且存活。

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