Kimura Takanobu, Sakamoto Kazuhisa, Yamazaki Kazuhiro, Tsunoda Shigeru, Tsuge Itaru, Tanaka Tomoharu, Kanemitsu Hideo, Takeda Takahide, Kawatou Masahide, Kumagai Motoyuki, Ikeda Tadashi, Minatoya Kenji
Department of Cardiovascular Surgery, Kyoto University, Kyoto, Japan.
Kyobu Geka. 2021 Sep;74(9):654-659.
A 31-year-old woman was referred to our institution because of aortoesophageal fistula (AEF) six months after the descending aortic replacement for acute aortic dissection. We operated one-stage repair of the AEF. Thoracoscopic esophagectomy was firstly performed in prone position from right thoracic cavity, and then the esophagus was reconstructed with gastric conduit via posterior mediastinal route with omental flap. Secondly, graft replacement of the descending aorta using lateral oblique straight incision was performed and the graft was covered with omental flap simultaneously. The postoperative course was uneventful, and she started oral intake on the 13th day after surgery. Although the one-stage surgery for the AEF is highly invasive, it could be a good option for selected cases.
一名31岁女性在因急性主动脉夹层行降主动脉置换术后6个月,因主动脉食管瘘(AEF)转诊至我院。我们对AEF进行了一期修复手术。首先在俯卧位经右胸腔行胸腔镜食管切除术,然后经后纵隔途径用带网膜瓣的胃管道重建食管。其次,采用外侧斜直切口行降主动脉移植置换术,同时用网膜瓣覆盖移植血管。术后病程顺利,患者术后第13天开始经口进食。虽然AEF一期手术创伤性很大,但对于特定病例可能是一个不错的选择。